Skip to main content

Full text of "The household physician : a twentieth century medica a practical description in plain language of all the diseases of men, women and children with the latest discoveries in medicine and most approved methods of treatment"

See other formats


MEDICA 


twentieth  century 
household  physician 


22900261376 


3 os  S’ ^ 


Digitized  by  the  Internet  Archive 

in  2016 


https  ://arch  i ve . org/detai  I s/b281 39616 


IMPORTANT  NOTICE 


■mHEREVER  numbers  are  seen  in  pa- 
rentheses— for  example,  on  page  208, 
under  Treatment  for  Lead  Palsy  will  be 
seen  (3J),  (32),  246) — these  numbers  re- 
fer to  the  Prescriptions  to  be  used;  said  pre- 
scriptions begin  on  page  1100  and  are  num- 
bered from  1 to  375, 


For  the  convenience  of  the  reader  we  have 
divided  the  indexes  as  follows: 

General  Index  Pages  1409  to  1426 

Index  of  Simple  Home  Remedies 

Pages  1426  to  1432 

Index  to  Homeopathic  Department 

Pages  1433  to  1436 

Index  to  Veterinary  Department 

Pages  1437  to  1440 


THE 


Household  Physician 


A TWENTIETH  CENTURY  MEDICA 


A PRACTICAL  DESCRIPTION  IN  PLAIN  LANGUAGE  OF  ALL 
THE  DISEASES  OF  MEN.  WOMEN  AND  CHILDREN 


WITH  THE 


LATEST  DISCOVERIES  IN  MEDICINE  AND  MOST  APPROVED 
METHODS  OF  TREATMENT.  BY  A CORPS  OF  EMINENT 
SPECIALISTS,  PRACTISING  PHYSICIANS  AND  SURGEONS 


HERBERT  E.  BUFFUM,  M.D. 

Fellow  of  the  Massachusetts  Medical 
Society. 


IRA  WARREN,  A.M.,  M.D. 

Fellow  of  the  Massachusetts  Medical 
Society,  etc. 

WILLIAM  THORNDIKE,  M.D. 

Fellow  of  the  Medical  Society,  and  Mem- 
ber of  Society  for  the  Improvement 
of  Medicine,  etc.,  and  others. 


A.  T.  LOVERING,  M.D. 

Member  of  the  Faculty  of  University 
School  of  Medicine 
Member  Boston  Homoeopathic 
Medical  Society 
A.  E.  SMALL,  A.M.,  M.D. 
Ex-President  of  the  Hahnemann 
Medical  College 
J.  HEBER  SMITH,  M.D. 
Professor  of  Materia  Medica,  Univer- 
sity School  of  Medicine,  and  late 
President  of  Massachusetts 
Homoeopathic  Society 


Veterinary,  CHARLES  P.  LYMAN,  F.R.C.V.S. 

Fellow  of  Royal  College  of  Veterinary  Surgeons,  England, 

President  United  States  Veterinary  Medical  Association,  ' 
Veterinarian-in-Chief  to  the  Agricultural  Department  at  Washington,  D.C., 
Member  Massachusetts  Veterinary  Society, 

Professor  of  Theory  and  Practice,  and  Dean  of  the  School  of  Veterinary  Medi- 
cine in  Harvard  University, 

Secretary  of  the  Board  of  Cattle  Commissioners  of  the  Commonwealth  of 

Massachusetts. 


FULLY  ILLUSTRATED  WITH  MANIKINS,  COLORED  AND 
HALF-TONE  PLATES 


THIS  BOOK  IS  PUBLISHED  STRICTLY  AS  A SUBSCRIPTION  BOOK  AND  TOJLBE 

SOLD  ONLY  AS  SUCH 

Printed  in  the  United  States 


JOSEPH  BEYER  & JOSEPH 

LONDON,  TORONTO  AND  NEW  YORK 
igo8 


Copyright,  1905 

PHYSICIANS’  PUBLISHING  CO.  (INC.) 


0 


THE  HOUSEHOLD  PHYSICIAN 
Is  registered  as  a Trade  Mark. 

Entered  in  Stationers’  Hall, 
London,  England. 

Right  of  Translation  is  Reserved. 


ViELLCChimtrm 

UBRfiaV 

Coll. 

we!^10tn®c 

Cc^l 

Cr. 

No. 

L 

m 


EMINENT  AUTHORITIES  CONSULTED 

WHOSE  WRITINGS  AND  WORKS  ON  MEDICINE  AND  SURGERY 
ARE  WITHOUT  QUESTION  THE  BEST  IN  THE  WORLD  AND 
REFERENCE  TO  WHICH  IN  TREATMENT  OF  SPECIAL 
DISEASES  WE  ARE  INDEBTED 


MEDICINE. 

Reginald  Fitz,  A.M.,  M.D. 

H.  C.  Wood,  A.M.,  M.D. 

Herbert  A.  Hare,  M.D.,  B.S.C. 

VENEREAL  DISEASES. 

Robert  W.  Taylor,  M.D. 

Prof.  Isodore  Newman  of  Vienna. 

DISEASES  OF  THE  SKIN. 

J.  N.  Hyde,  A.M.,  M.D. 

Prof.  Moriz  Kaposi  of  Vienna. 

DISEASES  OF  THE  EAR. 

Dr.  Adam  Politzer. 

MEDICINE. 

William  Osler,  M.D.,  F.T.S.,  F.R.C.P. 
James  M.  Anders,  M.D.,  Ph.D.,  LL.D., 
Philadelphia,  Pa. 

H.  R.  Arndt,  M.D. 

William  Borricke,  M.D., 

San  Francisco,  Cal. 

J.  M.  Dacosta,  M.D.,  LL.D. 

Dr.  Wilhelm  v.  Leube, 

Wurzburg,  Germany. 

A.  C.  COWPERTHWAITE,  M.D..  Ph.D., 
LL.D.,  Chicago,  III. 

Timothy  F.  Allen,  A.M.,  M.D., 

New  York. 

DISEASES  OF  THE  EAR,  NOSE  AND 
THROAT. 

Seth  Scott  Bishop,  M.  D. 

Horace  F.  Ivins,  M.D. 

D.  Braden  Kyle,  M.D. 

E.  B.  Dench,  Ph.B.,  M.D. 

DISEASES  OF  THE  SKIN. 

W.  Allan  Jamieson,  M.D.,  F.R.C.P., 
Edinburgh,  Scotland. 


SURGERY. 

F.  S.  Dennis,  A.M.,  M.D. 

J.  A.  W.  White,  M.D.,  Ph.D. 

W.  W.  Keane,  M.D. 

CHILDREN’S  DISEASES. 

Thomas  Rotch,  A.M.,  M.D. 

DISEASES  OF  THE  EYE. 

G.  E.  deSchweinitz,  A.M.,  M.D. 

DISEASES  OF  WOMEN. 

H.  J.  Garrigues,  A.M.,  M.D. 

H.  A.  Kelley,  A.M.,  M.D. 

E.  P.  Davis,  A.M.,  M.D. 

Richard  Norris,  A.M.,  M.D. 

SURGERY. 

William  W.  Keen,  M.D.,  LL.D., 
Philadelphia,  Pa. 

Prof.  E.  con  Bergmann, 

Berlin,  Germany. 

C.  E.  Fisher. 

T.  L.  Macdonald, 

Washington. 

H.  R.  Wharton,  M.D. 

DISEASES  OF  THE  STOMACH. 

Prof.  C.  A.  Ewald, 

Berlin,  Germany. 

DISEASES  OF  THE  HEART. 

Robert  H.'  Babcock,  A.M.,  M.D. 

VENEREAL  DISEASES. 

Prince  A.  Norrow,  A.M.,  M.D. 

URINARY  ORGANS. 

Clifford  Mitchell,  A.B.,  M.D. 

DISEASES  OF  CHILDREN. 

C.  SiGMTJND  UND  RAHE,  M.D. 

L.  Emmett  Holt,  M.D.,  LL.D. 
Charles  E.  Fisher,  M.D. 


PHARMACODYNAMICS. 

Richard  Hughes,  M.D.,  F.R.C.P., 
London.  Eng. 

GYNECOLOGY. 

G.  R.  SouTHwiCK,  M.D.,  Boston. 

T.  C.  Wood,  A.M.,  M.D.,  Cleveland,  O. 

C.  N.  A_.  L.  Reed,  A.M.,  M.D., 
Cincinnati,  O. 

HYGIENE. 

Charles  Harrington,  M.D.,  Boston. 

FEVERS. 

H.  C.  Allen,  M.D.,  Chicago,  111. 

OTOLOGY. 

Gorham  Bacon,  A.B.,  M.D., 

New  York. 

NERVOUS  DISEASES. 

Francis  X.  Dercum,  A.M.,  M.D., 
Ph.D.,  Philadelphia,  Pa. 

W.  R.  Gowers,  M.D.,  F.R.C.P., 

F.R.S.,  London,  England. 

Dr.  Ludwig  Hirt, 

Breslau. 

Charles  M.  Dana,  A.M.,  M.D., 

New  York. 

F.  Savary  Pearce,  M.D., 
Philadelphia. 


DISEASES  OF  THE  EYE. 

L.  Webster  Fox,  A.M.,  M.D., 
Philadelphia,  Pa. 

Charles  H.  May,  M.D., 

New  York. 


PATHOLOGY. 

Alfred  Stengel,  M.D., 
Philadelphia. 


RONTGEN  RAY. 

Carl  Beck,  M.D.,  New  York. 


MENTAL  DISEASES. 

Henry  D.  Berkley,  M D., 
Baltimore. 

S.  H.  Talcott,  A.M.,  M.D.,  Ph.D. 
Middletown,  N.  Y. 


OBSTETRICS. 

J.  Clifton  Edgar,  M.D., 
New  York. 

B.  C.  Hirst,  M.D., 

Philadelphia,  Pa. 

G.  W.  Varman,  M.D., 
New  York. 


PREFACE 

TO  THE 

Household  Physician. 


This  book  is  written  for  the  people.  It  is  based  on  the  assumption 
that  every  man — the  mechanic,  the  farmer,  and  the  day  laborer,  as 
well  as  the  professional  and  business  man — has  a right  to  all  the 
knowledge  he  is  capable  of  acquiring,  on  all  subjects,  medicine  not 
excepted.  The  book  aims,  therefore,  to  popularize  and  adapt  to  the 
many  what  has  been  claimed  as  belonging  only  to  the  few. 

We  do  not  hesitate  to  avow  that  our  sympathies  are  with  the  great 
masses,  who  may  be  called  the  bone  and  muscle  of  the  race.  They  are, 
in  the  main,  more  shrewd,  more  endowed  with  common  sense,  more 
simple  and  true  in  their  natural  instincts,  and  consequently  less  per- 
verted, than  many  of  those  who  claim  more  refinement  and  a higher 
place  in  the  social  scale. 

“All  men,”  says  Hippocrates,  one  of  the  great  fathers  of  medi- 
cine, “ought  to  be  acquainted  with  the  medical  art.  We  believe 
that  knowledge  of  medicine  is  the  sister  and  companion  of  wisdom.” 
Such  knowledge  would  shield  the  many  from  the  impositions  of  quack- 
ery. No  one  who  reads  this  book  thoroughly  will  be  often  imposed 
upon  thereafter  by  quack  nostrums,  or  quack  doctors.  Every  man’s 
physical  organization  is  his  own;  and  he  is  charged  with  the  responsi- 
bility of  taking  care  of  it.  To  do  this  properly,  he  needs  knowledge 
of  it,  and  to  withhold  this  from  him  is  another  form  of  the  old  oppres- 
sion, which  decreed  knowledge  and  power  to  the  few,  and  ignorance 
and  obedience  to  the  many. 

In  accordance  with  the  design  of  the  work,  it  has  been  written  in 
plain,  simple  English,  and  brought  within  the  comprehension  of  all 
who  have  medium  powers  of  mind. 


2 


PREFACE. 


This  book  was  prepared  by  a number  of  Medical  Experts  on  differ- 
ent diseases,  the  work  is  not  a compilation,  but  based  on  large  prac- 
tice and  wide  experience.  In  dealing  with  each  disease  we  have 
aimed  to  sketch  a brief  pen-and-ink  portrait,  so  like  it  that  every 
reader  shall  know  the  original  whenever  he  sees  it;  we  then  give,  in 
the  fewest  words,  the  best  treatment. 

No  work  of  the  sort  has  ever  explained  the  reasons  or  given  the 
whys  and  wherefores  of  medicine  anything  like  the  extent  of  this 
book,  thousands  of  which  are  on  their  mission  of  instruction,  and 
carrying  comfort  and  relief  to  as  many  homes  throughout  the  land. 

No  pecuniary  effort  has  been  spared  to  include  every  known  dis- 
covery of  medicine  and  nursing  to  make  this  book  absolute  perfec- 
tion, and  to  those  who  make  of  it  a careful  and  intelligent  study, 
it  will  prove  to  them  in  value  “ its  weight  in  gold.” 

The  book  is  extravagantly  illustrated  with  engravings  done  ex- 
pressly for  this  work;  the  colored  lithographs  and  manikins  were 
drawn  under  the  supervision  of  expert  surgeons,  and  add  much  to 
its  value. 

PHYSICIANS’  PUBLISHING  COMPANY. 


IMPORTANT  NOTICE 

'1X7HEREVER  numbers  are  seen  in  par- 
^ ^ entheses  — for  example,  on  page  208. 
under  Treatment  for  Lead  Palsy  will  be 
seen  (31),  (32),  (246)  — these  numbers  re- 
fer to  the  Prescriptions  to  be  used ; said  pre- 
scriptions begin  on  page  i 100  and  are  num- 
bered from  I to  3 7 5 . 


CONTENTS 


PAGE 

Preface  .............  1 

General  Introductory  Remarks  .......  6-14 

Anatomy — Structure  of  the  body — Chemical  Properties  of  the  Body — Physi- 
cal Properties  of  the  Body — Vital  Properties  of  the  Body — Anatomy  of 
the  Bones — Bones  of  the  Head — Bones  of  the  Trunk — Bones  of  the 
Upper  Extremities — Bones  of  the  Lower  Extremities — ^The  Joints — Uses 
of  the  Bones — The  Muscles — The  Teeth — Uses  of  the  Teeth — Digestive 
Organs — Urinary  System — Respiratory  Organs — Organs  of  Circulation — 
Absorbent  Vessels — Organs  of  Secretion — Vocal  Organs — Skin — Nervous 
System — Organs  of  Sight — Organs  of  Hearing  ....  16-57 

Hygiene — Life,  the  Infancy  of  Being — Nervous  System — Sensations — Sym- 
pathetic Nervous  System — Food  and  Digestion — Nature  and  Destination 
of  Food — Cost  of  Food — Amount  of  Food  Taken — Animal  and  Vegetable 
Food — Proportions  of  Animal  and  Vegetable  Food — Tea  and  Coffee 
— Water  — Exercise  — Passive  Exercise  — Rest  and  Sleep  — Objects  of 
Clothing — Bathing  and  Cleanliness — Air  and  Ventilation — Travelling — 
Amusements  ..........  59-127 

Temperaments  and  Constitution  of  the  Body  and  Symptoms  of  Diseases — 
Medication  and  Temperaments — ^The  Constitution — How  to  Examine  a 
Patient — Explanatory  Table  of  Symptoms — ^Temperature  of  the  Body 
— Strength  and  Warmth  from  Food  and  Drink — Sickness  During  Life — 
Human  Longevity — Weight  of  the  Human  Body — Symptoms  of  Differ- 
ent Diseases  ..........  128-15S 

Skin  Diseases — Congestive  Inflammation  of  the  Skin — Measles — Scarlet 
Fever — Smallpox — Varioloid — Chicken  Pox — Cow  Pox — Erysipelas — 
Nettle  Rash — Rose  Rash — Inflammatory  Blush — Watery  Pimples — 
Eczema  and  Salt  Rheum — Shingles — Itch — Rupia — Pemphigus — Mattery 
Pimples — Crusted  Tetter — Papulous  Scall — Scaly  Eruptions — Leprosy 
— Psoriasis  — Pityriasis — Dry  Pimples — Lupus — Warts  and  Corns — 
Mother’s  Marks — Nerves  of  the  Skin — Color  of  the  Skin — Disorders  of 
the  Sweat  Glands,  Oil  Glands  and  Tubes — Barber’s  Itch — Disorders  of 
the  Hair  and  Tubes — Lice — Bed-Bugs — Freckles — Corns — Bunions — 
Dandruff — Baldness  .........  155-185 

Diseases  of  Brain  and  Nerves — Brain  Fever — Softening  of  the  Brain — Ab- 
scess of  the  Brain — Tumors  of  the  Brain — Delirium  Tremens — Ine- 
briety— Enlargement  and  Shrinking  of  the  Brain — Water  in  the  Head — 
Dropsy  of  the  Brain — Cerebro-Spinal  Fever — Diseases  of  the  Spinal  Cord 
— ^Apoplexy — Sunstroke — Paralysis — Hydrophobia — Locked  J aw — ^i- 
lepsy— Catalepsy — St.  Vitus’  Dance — Cramps — Pains  of  Nerves — Tic 
Douloureux — Sciatica — Insanity — Melancholy- — Mania — Dimentia — I d i- 
ocy — Hypochondria — Hiccough — Fainting — Dizziness  of  the  Head — 
Nightmare — Headaches  ........  188-234 

Diseases  of  the  Throat — Nasal  Catarrh — Sore  Throat — Inflammation  of  the 
Mucous  Membrane — Inflammation  of  the  Windpipe — Elongation  of 
the  Uvula — Tonsilitis — Influenza — La  Grippe — Inflammation  of  the 
Epiglottis — Mumps 236-  267 

Diseases  of  the  Chest — Consumption — Causes  of  and  Cure  for — Diet  in  Con- 
sumption— Bronchitis — Swelling  of  Lungs — Enlargement  of  Air  Cells — 
Pulmonary  Apoplexy — Air  and  Water  in  the  Chest — Pleurisy — Lung 
Fever — Pneumonia — Typhoid  Pneumonia,  etc. — Asthma — Hay  Fever 

236-304 


3 


4 


CONTENTS. 


PAGE. 

Diseases  of  the  Heart — Sounds  of  the  Heart — Enlargement  of  the  Ventricles 
— Dilatation  of  the  Ventricles — Tumors  of  the  Heart — Softening  of  the 
Heart — Fatty  Degeneration  of  the  Heart — Shrinking  of  the  Heart — 
Inflammation  of  the  Heart  Case — Inflammation  of  the  Heart  Case  and 
Heart — Inflammation  of  the  Lining  of  the  Heart — Disease  of  the 
Heart  Valves — Water  in  the  Heart  Case — Palpitation  of  the  Heart — 
Neuralgia  of  the  Heart — Polypus  of  the  Heart — Displacement  of  the 

Heart 306-322 

Diseases  of  the  Abdominal  Cavity — Inflammation  of  the  Liver — Congestion 
of  the  Liver — Cirrhosis  of  the  Liver — Inflammation  of  the  Spleen — 
Jaundice — Gall  Stones — Inflammation  of  the  Stomach — Indigestion — 
Dyspepsia — Heart  Burn — Cramps  in  the  Stomach — Water  Brash — 
Vomiting — Seasickness — Milk  Sickness — Inflammation  of  the  Peri- 
tonium — Inflammation  of  the  Bowels — Appendicitis — Cancer  of  the 
Intestine — Intestinal  Obstruction — Colic — Air  Swellings — Constipation 
— Piles — Diarrhoea — Cholera  Morbus — Asiatic  Cholera — Dysentery — 

Worms — Inflammation  of  the  Kidneys — Inflammation  of  the  Bladder — 
Bright’s  Disease — Diabetes — Bleeding  from  the  Kidneys — Suppression, 
Retention  and  Inability  to  Hold  Urine — Gravel — Phosphatic  Deposits — 
Oxalic  Deposits — Acid  Deposits — Bladder  Stones — Dropsy  of  the  Belly 
— General  Dropsy  .........  324-392 

Venereal  and  Sexual  Diseases — Pox — Clap — Self-Pollution  . . 394-413 

Female  Diseases — Inflammation,  Ulceration  and  Enlargement  of  the  Neck 
of  the  Womb — Inflammation  of  the  Ovaries — Whites — Absence  of  the 
Menses — Profuse  Menstruation — Painful  Menstruation — Green  Sickness 
—Cessation  of  the  Menses — Hysterics — Polypus  of  the  Womb — Inflam- 
mation of  the  Womb — Falling  of  the  Womb — Tumors  of  the  Womb — 
Cancer  of  the  Womb — Ovarian  Tumors — Inflammation  of  the  Fallopian 
Tubes — Inflammation  of  the  Vagina — Itching  of  the  External  Parts — 
Tubal  Pregnancy — Sterility — Prevention  of  Pregnancy — Midwifery — 
Miscarriage — Abortion — Labor — Antiseptic  Dressings — Milk  Leg — Child- 
Bed  Fever — Convulsions — Hemorrhage — Nursing  Sore  Mouth — Broken 
Breast — Sore  Nipples — Married  Ladies  - Calendar  ....  415—451 

Care  of  Children  and  Diseases — How  to  Nurse  Sick  Children — Inflammation 
of  the  Mouth — Inflammation  of  the  Gums — Canker  of  the  Mouth — 
Difficult  Teeth  Cutting — Croup — Spasm  of  the  Glottis — Whooping 
Cough — Diarrhoea — Summer  Complaint — Colic — Falling  of  the  Bowel — 
Gastric  Fever — Rickets — Mesenteric  Disease — Blue  Disease — Fits  . 483-508 
Diseases  of  the  General  System — Miscellaneous  Diseases — Blood — Anaemia — 
Chlorosis — Leucocytosis — Bacteriology — Fever — Typhoid  Fever — Pre- 

vention of  Typhoid — Bilious  Remittent  Fever — Congestive  Fever — 
Fever  and  Ague — Yellow  Fever — Rheumatism — Gout — Scrofula — Scurvy 
— Purple  Disease — Diphtheria — Canker  . . . . . 510-540 

Diseases  Peculiar  to  Modern  Times — Old  Age  and  its  Diseases — Changes  Oc- 
curring in  Advanced  Life — Medical  Treatment  of  the  Old — Diseases  of 
the  Old — Bronchial  Flux  ........  542-558 

Accidents  from  Noxious  Vapors — Drowning — Lightning — Hanging — Fire — 
Water — Poisoning  and  Antidotes  for  Same — Mineral  Poisoning — Vege- 
table and  Other  Poisons  ........  560-569 

Surgical  Diseases — Modern  Surgery — Inflammation — Suppuration  and  Abscess 
— Mortification — Pyaemia — Ulceration  and  Ulcers — Boils — Carbuncle — 
Malignant  Pustule — Burns  and  Scalds — Frost  Bite — Chilblains — Me- 
chanical Injuries — Septic  Wounds — Incised  Wounds — Rules  for  Examin- 
ing and  Dressing  Wounds — Antiseptic  Dressings — Way  Wounds  Unite 
— Punctured  Wounds — Lacerated  Wounds — Gunshot  Wounds — Poisoned 
Wounds — Fractures — Way  Broken  Bones  Unite — Dislocations — Sprains 
— Pereostitis — Different  Diseases  of  Bones — White  Swelling — Bunions — 
Tumors — Cancer — Felon — Polypus — Piles — Wry  Neck — Deformities  of 
the  Spine — Rupture — Varicose  Veins — Aneurisms — Wens — Stye  — Op- 
thalmia — Imperfect  Vision— Short  and  Long  Sight — Affections  of  the  Ear 
— Ingrowing  Toe  Nail — How  to  Stop  Flow  of  Blood — Compression  of 
Arteries — Anaesthetics — Care  of  the  Teeth — Ulcer  of  the  Stomach — 
Glanders — X-Ray — Radium — Flatfoot — Bandages — How  to  Put  them 
on 571-680 


CONTENTS. 


5 


Homosopathic  Treatment  of  Diseases — Forms  of  Medicine  for  Administration — 
Selecting  and  Using  Remedies — Care  of  Medicines — General  Considera- 
tions— Diseases  of  the  Ear — Diseases  of  the  Eye  and  Eyelids — Diseases 
of  the  Respiratory  Organs — Baldness — Ringworm — Blackheads — Ery- 
sipelas— Prickly  Heat — Malignant  Pustule — Skin  Diseases — Diseases  of 
the  Digestive  Organs — Diseases  of  Organs  of  Circulation — Diseases  of 
the  Genito-Urinary  Organs — Diseases  of  Infants  and  Children — Diseases 
of  Women — Surgical  Diseases — Diseases  of  the  General  System  and 
Miscellaneous  Diseases — Diseases  of  the  Nervous  System  . . 682-892 

Processes  of  Hydropathic  Treatment — Different  Baths — Sea  Bathing — In- 
jections— Rules  for  Using  Water — Wet  Bandages — Compresses — Wet 
Sheet  Pack — Wet  Dress — Half  Pack — Folded  Wet  Sheet — Rubbing  Wet 
Sheet — Douche,  Shower,  Cataract,  Hose,  Wave,  Plunge,  Head,  Leg,  Sitz, 
Wash  Tub,  Sponge,  Foot,  Nose,  Eye  and  Ear  and  Mouth  Baths  . 894-917 
Domestic  Management  of  the  Sick  Room — Fumigation — Freezing  Mixtures — 
Attendants — Prognostics — Bed  Sores — Diet  in  Disease  and  Convales- 
cence— Fluid  Aliments  ........  920-952 


Art  and  Science  of  Cooking  for  the  Sick  Room 

How  to  Prepare  Wines  and  Tonics  for  the  Convalescent 

Dieting  in  Regard  to  Health  .... 

“ “ Disease  ...... 


Bathing — Russian,  Turkish,  Vapor  and  Other  Baths 
Medicines  and  Their  Preparations 
Proprietary  and  Patent  Medicines 
Woman  Beautiful — A Treatise  on  How  to  Keep  Young 
Physical  Culture — Gymnastics — Dumb-Bell  Exercise — Jiu 
Course  in  Physical  Culture — ^Whitely  Exerciser 


. 953-962 
. 96.3-969 
. 970-972 
. 973-974 
. 975-978 
982-1140 
1141-1146 
1148-1166 
Jitsu — Special 

1169-1214 

Veterinary  Medicine — Definitions — The  Pulse — Respiratory  Organs — Temper- 
' ature — General  Diseases  Common  to  all  Animals — General  Plethora — 

Anaemia — Blood  Poisoning — Anthrax — Expressions  Peculiar  to  Ani- 
mals— Hydrophobia — Rabies — Glanders — T uberculosis — Lockj  aw — Pox 
— Lump  Jaw — Horse  Ail — Epizootic — Pneumonia — Distemper — Foot 
and  Mouth  Disease — Texan  Cattle  Fever — Hemorrhage — Rinderpest — 
General  Inflammation — Catarrh — Sore  Throat — Bronchitis — Heaves — 
Asthma — Congestion  of  the  Lungs — Pleurisy — Hydrothorax — Disorders 
of  Organs  of  Digestion — Diseases  of  the  Intestines — Diseases  of  Urinary 
Organs — Diseases  of  the  Brain — Diseases  of  the  Spinal  Cord — Diseases 
of  the  Skin — Diseased  Condition  of  the  Joints — Diseases  of  the  Foot — 
Shoeing — Parasitic  Diseases — Methods  of  Giving  Medicine — Table  of 
Doses — Prescriptions  .......  1217-1403 

Glossary  1405-1408 


H 


ILLUSTRATIONS 


This  book  contains  about  five  hundred  illustrations,  the  principal  ones  of  which  are 

given  below. 


HALF-TONES. 


PAGE. 

A Perfect  “Cupid  Bow”  Mouth  .......  1165 

A Physical  Culture  Student  . . . . . . . . 1168 

Back  and  Shoulder  Development  .......  1171 

Bandages  ...........  674-680 

Blackberry  Vine  ..........  1097 

Body  Poise  ...........  1149 

Cayenne  Pepper  ..........  1097 

Celery  ............  1097 

Chest  Expansion  ..........  1171 

Compression  of  Arteries  .........  658-660 

Correct  Way  to  Walk  .........  1149 

Dandelion  . ..........  1097 

Development  of  the  Female  Figure  after  Physical  Culture  Treatment  . 1205 

Exercise  for  Stout  Women  . . . . . . . . 1151 

Exercise  for  Strengthening  the  Back  .......  1151 

Exercise  to  Reduce  Double  Chin  . . . . . . . 1159 

Exterior  of  the  Cow  . ........  1398 

Flatfoot  ...........  672 

How  to  Lift  the  Sick  and  Injured  .......  568-569 

Hydrangea  ...........  1098 

Jiu-Jitsu  Holds 1188-1198 

Lemons  ............  1094 

Lifting  Heavy  Dumb-bell  .........  1174 

Making  the  Arms  Plump  . . . . . . . . 1157 

Manicuring  ...........  1160 

Massaging  Forehead  . . . . . . . . . 1156 

“ Neck  and  Shoulders  ........  1157 

“ Scalp  ..........  1163 

Medicine  Cases  ..........  892 

Muscles  of  the  Horse  .........  1392 

“ “ “ Human  Body  ........  31-32 

Nerves  and  Arteries  of  the  Brain  . . . . . . . 186 

“ of  the  Face  ..........  876 

Perfect  Arm  Development  ........  1173 

Plaster  Treatment  for  Wrinkles  .......  1156 

Points  of  the  Horse  ..........  1389 

Poke  ............  1098 

Pumpkin  ...........  1098 

Reduction  of  Obesity  .........  1203 

Removing  Hairs  from  Eyebrows  . . . . . . 1163 

Rested  by  Music  ..........  1160 

Skeleton  of  the  Cow  .........  1399 

“ “ “ Horse  .........  1395 

“ “ “ Human  Body  ........  21 

“ “ “ Sheep 1402 

“ and  Internal  Organs  of  the  Dog  ......  1403 

Skull  Cap 1099 

Star  Grass  ...........  1099 

Steaming  the  Face  1154 


ILLUSTRATIONS. 


7 


PAGE. 


Teeth 499 

“ of  the  Cow  ..........  1401 

“ “ “ Horse  . . ...  . . 1397 

The  Way  the  Baby  Should  be  Held  in  Quieting  and  Feeding  . 485 

Tomato 1098 

Tulip  Tree 1099 

Use  of  Flesh  Brush  . . . . . 1154 

White  Pond  Lily  ..........  1099 

Woman  Beautiful  ..........  1147 


COLORED  PLATES. 


Manikin  of  Human  Head 
Muscles  of  Human  Body  . 

Manikin  of  Human  Trunk 
Nerves  of  the  Human  Body 
Measles  and  Scarlet  Fever 
Small  Pox  ..... 

Erysipelas  ..... 

Results  of  Strong  Drink  . 

Heart,  Lungs,  Stomach  and  Kidney  . 
Syphilitic  Eruptions 

“ Affections  of  the  Throat 
Diseases  of  the  Womb 
Womb  . . .... 

Arteries  and  Veins  of  the  Human  Body 
Internal  Organs  of  Human  Body 
Medicinal  Plants  (Aloes,  etc.) 

“ “ (Bittersweet,  etc.) 

“ “ (Dandelion,  etc.) 

“ “ (Ground  Ivy,  etc ) 

“ “ (Hemlock,  etc.) 

“ “ (Mullein,  etc.) 

“ “ (Plantain,  etc.) 

“ “ (Thoroughwort,  etc.) 

Internal  Organs  of  Horse  . 

“ “ “ Cow 

“ “ “ Sheep  . 

" “ *'  Dog  , , , 


Pacing 


page  188 


“ 29 

‘ 60 
‘ 66 
‘ 156 

‘ 160 
‘ 163 

‘ 194 

‘ 310 

‘ 396 

‘ 404 

‘ 420 

‘ 442 

■ 658 

‘ 682 


Between  pages  988  and  1064 


Facing  Title  page  1215 
“ “ 1272 

“ . “ 1306 

“ “ 1342 


GENERAL  INTRODUCTORY 
REMARKS 


Progress  of  fledicine 

Medicine  may  be  divided  into  a science  and  an  art.  It  is  a sci- 
ence as  it  presents  facts  and  evolves  principles;  an  art  as  it  consists 
of  rules  for  practice.  For  its  present  attainments  it  is  indebted  partly 
to  researches  scientifically  conducted,  and  partly  to  empirical  dis- 
covery. 

As  a science,  medicine  is  chiefly  indebted,  and  must  ever  be,  to  the 
members  of  what  is  called  the  “regular  profession.”  This  body  of 
men  embraces  a large  number  who  are  alike  ornaments  of  the  race, 
and  lights  of  their  profession.  It  is  to  the  writings  of  this  class  that 
every  student  must  go  who  would  qualify  himself  for  the  proper  dis- 
charge of  the  duties  of  a physician;  and  he  who  attempts  the  prac- 
tice of  medicine  without  a knowledge  of  standard  medical  writings 
is  either  a fool  or  a knave  — either  without  the  brains  to  understand 
science,  or  destitute  of  the  honesty  to  deal  fairly  with  men. 

Hydropathy.  — Or  the  plan  of  treating  diseases  by  water.  The 
singularly  careful  avoidance,  by  the  whole  medical  faculty,  for  many 
ages,  of  the  article  of  pure  water  as  a medicinal,  or,  rather,  health- 
imparting  agent,  was  anything  but  creditable. 

It  is  now  admitted  by  all  sensible  men  that  water,  cold  and  warm, 
used  at  proper  times  and  to  a reasonable  extent,  has  great  power 
over  several  diseases,  and  is  a powerful  promoter  of  health. 

Homoeopathy.  — This  mode  of  practice  is  of  comparatively  recent 
origin;  but  it  has  already  sunk  itself  deep  into  the  popular  heart, 
and  has  drawn  to  its  support  many  of  the  wealthy,  the  cultivated, 

and  the  intelligent,  in  our  most  refined  communities.  They  give 

8 


GENERAL  INTRODUCTORY  REMARKS  9 

great  attention  to  exercise,  diet,  etc.,  — which  contribute  very  power- 
fully to  preserve  health,  and  to  restore  it  when  lost. 

Eclectics.  — There  is  a large  growing  class  of  physicians,  called, 
at  first,  after  the  founder  of  the  school,  Thomsonians.  Subsequently, 
they  were  generally  known  as  Botanic  Physicians.  Now  they  pass 
under  the  title  of  Eclectics. 

These  men,  directing  their  attention,  at  first,  chiefly  to  cayenne 
and  lobelia,  have  gradually  extended  their  zealous  researches  over 
the  vegetable  kingdom,  and  have  gathered  much  information  worthy 
to  be  preserved. 

The  education  and  talents  of  this  class  of  practitioners  have  grad- 
ually risen,  year  by  year,  until  they  have  several  medical  schools, 
where  students  are  well  instructed  in  the  principles  of  medicine,  by 
men  of  ability.  They  have  also  good  literature,  especially  in  the 
department  of  materia  medica.  The  list  of  remedies  they  have  given 
to  the  world,  drawn  from  our  home  plants,  are  of  great  value.  We 
regard  them  as  equal  to  all  we  were  previously  in  possession  of  from 
the  vegetable  kingdom.  The  substitution  of  vegetable  remedies,  in 
most  cases,  for  mercurials,  cannot  be  too  highly  prized. 

Physiologists.  — Besides  these  various  direct  practitioners  of 
medicine,  there  is  the  large  and  intelligent  class  of  physiologists,  in- 
cluding the  phrenologists,  who  nearly  discard  medicine,  and,  appeal- 
ing to  the  laws  of  life  established  by  the  Creator,  urge  temperance  in 
eating  and  drinking;  exercise  in  the  open  air;  securing  of  pure  air 
by  ventilating  dwellings,  schoolhouses,  and  churches;  bathing  in 
cold  and  warm  water;  cheerfulness  of  mind;  and  the  cultivation  of 
the  Christian  virtues,  as  the  only  rational  modes  of  securing  health 
and  life. 

We  confess  we  are  inclined  to  forgive  this  class  their  error  in  ban- 
ishing medicine,  in  view  of  their  zeal  and  success  in  disseminating 
hygienic  information  of  the  utmost  value  and  importance  to  man- 
kind. Put  man  into  harmony  with  nature,  and  establish  over  him 
the  empire  of  reason,  and  their  theory  would  be  excellent;  but  as 
things  are,  medicines  are  “necessary  evils.” 


10 


GENERAL  INTRODUCTORY  REMARKS 


Progress  of  Medicine.  — The  art  and  science  of  medicine  have 
made  rapid  progress  in  the  last  few  years  and  are  rapidly  advancing. 

The  Chemistry  of  Man,  commonly  called  Animal  Chemistry,  is 
opening  new  sources  of  light. 

The  result  is  that  students  have  now  before  their  minds,  and  are 
endeavoring  to  solve  and  act  upon  as  fast  as  possible,  inquiries  and 
propositions  like  these : — 

What  is  the  chemical  composition  of  the  solids  and  fluids  of  the 
healthy  human  body? 

What  is  the  nature  of  the  changes  which  occur  in  the  composition 
of  the  solids  and  fluids  during  disease? 

What  alterations  in  the  chemical  composition  of  the  solids  and 
fluids  take  place  during  the  operation  of  medicines? 

Before  it  can  exert  any  remote  action  on  the  animal  economy,  a 
remedy  must  be  absorbed. 

Before  it  can  be  absorbed,  it  must  be  soluble  in  the  fluids  of  the 
living  body. 

Medicines  are  subject  to  chemical  changes  during  their  passage 
through  the  system. 

These  changes  are  regulated  by  ordinary  chemical  laws,  and  may, 
therefore,  to  some  extent,  be  foretold  and  made  available  in  the  cure 
of  disease. 

These  chemical  laws  are  disturbed  and  varied,  to  some  extent,  by 
the  law  of  vitality,  — just  as  the  magnetic  needle  is  made  to  vary  by 
disturbing  forces. 

What  are  these  disturbances,  and  to  what  extent,  and  under  what 
circumstances  do  they  occur? 

With  these  and  similar  inquiries  and  propositions  before  his  mind, 
diligently  studied,  a physician  can  prescribe  with  intelligent  aim. 
He  will  not  know  everything,  to  be  sure,  but  what  he  does  know  he 
will  have  a reason  for  knowing.  If  he  give  a medicine,  he  will  have 
in  view  the  chemical  changes  of  the  solids  and  fluids  of  the  body, 
known  to  be  produced  by  the  disease  he  is  combating.  He  will  also 
keep  in  mind  the  solution  of  the  medicine  in  the  fluids  of  the  body, 


GENERAL  INTRODUCTORY  REMARKS 


11 


and  the  chemical  reaction  between  its  components  and  the  acids, 
alkalies,  etc.,  found  in  the  alimentary  tube  and  elsewhere. 

As  the  science  of  medicine  advances,  and  becomes  liberal  and  ec- 
lectic in  its  character,  gathering  from  all  systems  the  best  attested 
facts  — medical  practitioners,  who  would  meet  the  wants  of  the  age, 
must  be  men  of  progress.  The  light  of  to-morrow,  with  them,  must 
modify  and  improve  the  light  of  to-day.  They  must  knock  every 
hour  for  admission  into  some  new  apartment  of  nature. 

Need  of  Liberality.  — That  medical  progress  may  be  real, 
physicians  must  be  free  from  bigotry.  They  must  have  no  narrow 
prejudices  against  any  man,  or  class  of  men;  but  be  ready  to  exam- 
ine candidly  any  new  thought  or  new  remedy  brought  to  their  notice, 
from  whatever  source  it  may  come. 

Conservative  Leaders.  — There  are  no  influences  which  hold 
so  steady  a check  upon  medical  progress  as  the  conservative  leaders 
in  many  of  our  medical  associations.  These  men  have  strong  faith 
in  caste,  and  in  the  right  of  the  few  to  govern  the  many.  In  the 
low  places  of  society,  they  look  for  nothing  but  ignorance  and  pov- 
erty. These  are  the  men  who  regard  knowledge  as  a contraband 
article.  They  object  very  strongly  to  the  enlightenment  of  all  classes 
in  Anatomy,  Hygiene,  and  Medicine.  This  prejudice  should  be  elim- 
inated. 

The  True  Physician.  — How  different  the  character  of  the  true 
man  and  physician.  He  is  genial  in  his  disposition.  He  has  no  dis- 
likes and  antipathies,  and  hates  no  men  except  tyrants.  He  accepts 
knowledge,  though  it  come  from  the  humblest  source;  believing  there 
is  no  experience  but  will  repay  a study  of  it,  and  no  husbandman’s 
ploughshare  but  turns  up  a soil  worth  analyzing.  He  belongs  ex- 
clusively to  no  party,  and  can  be  approached  easily  by  respectable 
men  of  every  stamp. 

What  is  now  Wanted.  — The  foregoing  remarks  indicate  one 
great  leading  want,  in  order  that  medical  knowledge  may  increase. 
It  is  liberality  in  the  true  and  full  sense.  We  want  true  men  in  high 
places,  who  will  let  their  light  shine  everywhere. 


12 


GENERAL  INTRODUCTORY  REMARKS 


Beyond  this,  and  of  nearly  equal  importance  with  it,  we  want  med- 
ical knowledge  diffused  among  the  people.  We  want  — what  the 
world  has  never  seen  — a popular  medical  literature.  We  want  the 
temple  of  Esculapius  pulled  down,  and  the  priests  turned  into  the 
streets  to  become  teachers  of  the  multitude,  rather  than  worshippers 
in  the  inner  sanctuary. 

We  know  this  want  will  be  stoutly  denied,  but  not,  we  think,  on 
well-considered  grounds.  We  do  not  think  it  necessary  to  confine 
a knowledge  of  the  soul  to  the  ministers  of  religion.  There  is  no 
branch  of  theology  which  we  do  not  deem  it  proper  for  laymen  to 
study;  we  even  popularize  it  for  our  children.  In  the  obscurest  towns, 
laymen  who  follow  the  plough  or  push  the  plane,  become,  in  many 
cases,  eminent  theologians.  Why  should  they  not  study  the  lower 
science  which  relates  to  the  body?  They  have  not  been  able  to  here- 
tofore, because  its  mysteries  have  been  purposely  hidden  under  tech- 
nicalities. 

It  is  said  that  those  who  begin  to  read  upon  medicine,  are  very  apt 
to  imagine  themselves  afflicted  with  the  various  symptoms  they  find 
described.  To  some  small  extent  this  is  true;  but  it  is  also  true  that 
the  light  they  obtain  relieves  them  from  many  apprehensions  which 
their  previous  ignorance  allowed  to  prey  upon  them. 

Some  physicians  oppose  the  popularizing  of  this  kind  of  knowledge 
too  often,  we  fear,  upon  the  sordid  ground  of  self-interest.  They 
think  their  own  services  will  be  less  sought. 

We  do  not  dispense  with  the  services  of  ministers  because  the 
people  study  theology,  neither  shall  we  cease  to  employ  teachers 
and  practitioners  of  medicine  when  each  man  and  woman  is  wise 
enough  to  study  the  healing  art.  The  principal  change  we  shall 
witness  will  be  much  larger  attainments  in  knowledge  among  practi- 
tioners. 

The  teachers  of  any  art  or  science  are  obliged  to  keep  in  advance 
of  their  pupils.  Let  medicine  become  a popular  study,  and  we  shall 
have  very  few  ignorant  physicians,  and  quackery  will  become  one  of 
the  impossibilities.  Homoeopathists,  Eclectics,  Hydropathists,  and 


GENERAL  INTRODUCTORY  REMARKS 


13 


Physiologists  believe  in  scattering  medical  books,  stripped  of  their 
technicalities,  among  the  multitude. 

This  is  one  of  the  missions  of  this  book. 

How  many  men  understand  the  laws  of  health?  How  many 
women  suffer  untold  agony  through  pure  ignorance  of  their  physical 
construction?  Children  are  taught  history,  mathematics,  and  other 
branches  of  learning,  but  know  absolutely  nothing  of  their  anatomy 
— the  function  of  their  stomach,  lungs,  brain,  nerves  or  circulation. 
This  being  the  case,  is  it  a wonder  so  many  boys  and  girls  enter  matu- 
rity unprepared  physically  for  the  duties  demanded  of  them,  and 
consequently  suffer  for  their  ignorance?  How  different  and  hap- 
pier would  their  future  life  be  if  they  were  to  receive  proper  physical 
care  and  given  proper  instruction. 

This  book  is  written  in  plain  English,  imparting  knowledge  indis- 
spensable  to  the  family,  father,  mother,  and  children,  who,  by  taking 
advantage  of  this  opportunity,  by  careful  and  intelligent  study,  can 
learn  how  to  avoid  and  ward  off  sickness  and  disease,  as  well  as  to 
administer  in  case  of  illness  to  themselves  and  other  members  of  the 
family. 

But  it  must  be  borne  in  mind  that  in  many  cases,  the  services  of  a 
physician  are  indispensable,  and  unless  the  reader,  by  following  the 
symptoms  herein  given,  is  able  to  diagnose  the  ailment,  and  if  a 
marked  improvement  is  not  noticed  in  the  patient  from  the  rem- 
edies given,  no  time  should  be  lost  in  calling  a physician. 


PHYSICIANS’  PUBLISHING  CO. 


WONDERS  OF  THE  HUMAN  BODY. 


How  to  Keep  Well. 

The  solar  plexus,  or  brain,  never  ceases  to  operate  while  soul 
remains  in  the  temple  — never  sleeps  — therefore  never  needs  to  be 
awakened.  The  power  — all  power  — given  to  the  cerebrum  and 
cerebellum  comes  from  the  solar  center.  Thus  digestion  of  food, 
circulation  of  blood,  inhaling-breathing  in  the  aerial  elements,  is 
carried  on  through  the  wondrous  mechanism  of  the  vascular  and 
nervous  system  of  man’s  body. 

The  body,  flesh,  bone,  blood,  hair,  nails,  etc.,  is  all  that  seers, 
philosophers,  prophets,  and  alchemists  have  sought  and  smig  through- 
out the  centuries.  But  materialism  forever  looks  away,  here  and 
there,  for  that  which  lies  between  the  soles  of  man’s  feet  and  the 
crown  of  his  head.  In  the  language  of  Epictitus,  ‘‘Unhappy  man, 
thou  carriest  a god  about  with  thee  and  knowest  it  not.” 

At  maturity  the  human  skeleton  contains  about  165  bones  so 
delicately  and  perfectly  adjusted  that  Science  has  despaired  of  ever 
imitating  it.  The  muscles  are  about  500  in  number.  Length  of 
alimentary  canal  32  feet.  Amount  of  blood  in  average  sized  adult 
30  pounds,  or  one  fifth  the  weight  of  the  body. 

The  heart  is  six  inches  in  length  and  four  inches  in  diameter  and 
beats  70  times  per  minute,  4200  times  per  hour,  100,800  per  day, 
36,720,000  per  year;  at  each  beat  two  and  one-half  ounces  of  blood 
are  thrown  out  of  it,  175  ounces  per  minute,  656  pounds  every  hour, 
or  about  eight  tons  per  day.  All  the  blood  in  the  body  passes  through 
the  heart  every  toee  minutes.  During  70  years  the  heart  lifts 
270,000,000  tons. 

The  lungs  will  contain  about  one  gallon  of  air  at  their  usual  in- 
flation. 

We  breathe,  on  an  average,  1,200  per  hour  and  inhale  24,000 
gallons  per  day. 

The  aggregate  surface  of  air  cells  of  the  lungs  exceeds  20,000  square 
inches,  an  area  nearly  equal  to  a room  12  feet  square. 

The  average  weight  of  the  brain  of  an  adult  male  is  three  pounds 
and  eight  ounces;  female,  two  pounds  and  four  ounces. 

The  female  brain  more  than  makes  up  in  fineness  of  texture  what  it 
laicks  in  weight,  compared  with  the  male. 

14a 


146 


WONDERS  OF  THE  HUMAN  BODY. 


The  nerves  are  all  connected  with  the  brain  directly  or  by  the 
spinal  marrow. 

The  nerves,  together  with  their  branches  and  minute  ramifications, 
exceed  10,000,000  in  number,  and  form  a body-guard  greater  than 
any  army  ever  marshalled. 

The  skin  is  composed  of  three  layers,  and  varies  from  one  fourth 
of  an  inch  to  one  inch  in  thickness.  Its  average  area  in  an  adult  is 
estimated  at  2,000  square  inches.  The  atmospheric  pressure  being 
about  14  pounds  to  the  square  inch,  a person  of  medium  size  is  subject 
to  a pressure  of  40,000  pounds.  Each  square  inch  of  skin  contains 
3,500  sweating  tubes,  or  perspiratory  pores,  each  of  which  may  be 
likened  to  a little  drain  tile  one  fourth  of  an  inch  long,  making  an 
aggregate  length,  of  all  the  pores  placed  end  to  end,  202,000  feet  or 
about  40  miles. 

The  ashes  of  an  average  body  weigh  four  to  five  pounds. 

Air  breathed  into  the  arteries  (air  carriers  — the  ancients  knew) 
unites  with  the  cell,  salts  of  iron,  potash,  lime,  etc.,  the  mineral 
base  of  blood,  and  is  thus  through  the  wondrous  affinities  and  alchem- 
ical transmutations  precipitated  as  flesh  and  bone  by  the  same 
Infinite  Intelligence  that  materializes  vegetables,  fruits,  or  flowers. 

The  organic  portion  of  food,  i.e.,  the  oil,  albumen,  fibrin,  etc.,  is 
consumed,  chemically  burned  in  stomach  and  intestinal  tract,  to  set 
free  stored-up  energy  (motion)  motive  power  to  run  the  human  ma- 
chine, so  the  process  of  inhaling  air  — raw  material  for  blood  — may 
go  on. 

Through  this  chemical  process  of  burning,  called  digestion,  the 
mineral  salts  of  iron,  potassium,  sodium,  silica,  hme,  and  magnesia 
are  set  free  and  enter  the  circulatory  avenues  through  the  dehcate 
hair-like  tubes  that  cover  the  mucous  membrane  of  all  internal  viscera; 
these  tubes  are  called  absorbents.  The  mineral  or  cell  salts  are  the 
foundation  of  blood. 

Chemists  now  agree  that  there  is  but  one  substance  known  to 
man,  and  from  it  all  things  are  made  that  are  made. 

The  multiple  forms  of  this  substance  constitute  the  visible  universe. 

The  body  of  man  is  an  epitome  of  the  whole. 

Mankind  is  on  the  verge  of  the  discovery  that  the  universe  is  a 
perfect  machine,  always  in  perfect  order,  and  always  running,  and 
that  all  that  is  needed  to  supply  man’s  every  necessity  is  intelligent 
direction  and  adjustment  of  the  machinery. 

Man  cannot  create  force  — it  eternally  exists.  Man  can  direct 
force  for  his  benefit  or  pleasure  just  in  the  degree  that  he  obtains 
knowledge  of  the  nature  and  qualities  of  force. 

Certainly  the  human  body  is  fearfully  and  wonderfully  made. 

Children,  when  they  reach  the  age  of  comprehension,  should  be 
taught  the  great  importance  and  tlie  wonderful  working  of  their 
internal  machinery,  or  in  other  words  the  use  of  their  lungs,  stomach, 


WONDERS  OF  THE  HUMAN  BODY. 


14  c 

liver,  and  kidne)'^s,  that  they  make  proper  use  of  them,  thereby  pre- 
serving their  health,  and  growing  to  be  strong  men  and  women. 

It  is  never  too  late  to  learn,  and  if  you  do  not  thoroughly  under- 
stand your  ‘'internal  machinery,”  you  should  certainly  do  so. 

In  the  first  place  your  external  body  should  receive  proper  care. 
This  is  absolutely  necessary  and  is  the  first  law  of  health. 

A sponge  bath  should  be  taken  every  morning;  this  opens  the  pores 
of  the  skin  and  allows  it  to  throw  off  the  poison  which  accumulates 
through  the  pores  every  twenty-four  hours. 

After  you  bathe,  exercise  your  lungs  by  deep  breathing.  To  do 
this,  extend  the  hands  straight  in  front  of  you,  bringing  them  up 
over  your  head,  at  the  same  time  taking  a long  deep  breath;  let  the 
air  out  of  your  lungs  slowly,  as  you  lower  your  arms  to  your  sides. 
Do  this  several  times,  as  the  average  person  is  apt  to  acquire  the 
habit  of  drawing  the  air  very  little  into  the  lungs,  but  the  fresh  air 
should  be  drawn  in  full;  way  to  the  lower  part  or  base  of  the  lungs, 
for  the  blood  receives  the  oxygen  (which  gives  life  to  the  blood) 
from  the  air,  and  to  feed  the  blood  properly,  deep-drawn  breaths 
should  be  taken  frequently. 

After  this  exercise  drink  a glass  of  pure  fresh  water,  this  will  give 
you  an  appetite  for  breakfast,  and  before  you  sit  down  to  the  table 
just  bear  in  mind  that  food  is  something  like  your  coal-bin,  and 
your  stomach  like  your  stove. 

If  you  want  a good  fire  in  your  stove  you  must  put  into  it  good 
clean  wood  and  good  coal,  free  from  rubbish ; therefore,  put  into  your 
stomach  proper  food  in  a proper  way,  that  your  stomach  may  take 
good  care  of  it,  making  good  blood  which  is  vitality. 

Eat  ripe  fruit,  good  meat,  oatmeal,  eggs,  etc.,  but  never  hot  or 
soggy  bread,  and  do  not  drink  water  with  your  meals;  one  cup  of  tea 
or  coffee  may  be  taken,  but  no  more.  Chew  your  food  slowly  and 
well;  this  causes  the  flow  of  saliva  from  the  glands  in  the  mouth  and 
throat  and  sends  the  food  to  your  stomach  in  proper  condition  for 
stomach  and  liver  to  take  care  of  it. 

The  “liver”  is  the  most  wonderful  organ  of  the  body.  All  the 
corpuscles  (solid  particles  in  the  blood)  die  every  six  weeks  and 
have  to  be  disposed  of ; the  liver  does  most  of  this  work,  by  grinding 
them  up  and  working  them  over  into  something  of  use. 

The  red  corpuscles  have  potash  in  them,  which  makes  bile;  this 
bile  is  a kind  of  lye  which  is  a disinfectant;  this  passes  into  the 
small  intestines  and  should  destroy  all  the  poisonous  germs  in  the 
food  before  it  passes  into  the  blood. 

If  the  liver  does  not  do  the  work  as  it  should  the  dead  matter 
accumulates  in  the  body  instead  of  being  discharged  through  the 
bowels,  kidneys,  and  pores  of  the  skin. 

The  liver, is  a closed  door  which  keeps  poisons  out  of  the  body. 
The  kidneys,  skin,  and  lungs  are  open  doors  to  let  the  poison  escape 


14d 


WONDERS  OF  THE  HUMAN  BODY. 


from  the  body.  When  there  comes  such  a pressure  upon  the  liver 
from  over-eating  or  too  rich  or  poor  food,  it  cannot  keep  the  poison 
out,  but  lets  it  pass  into  the  blood,  so  it  is  not  purified. 

This  causes  biliousness,  a dull  brain,  yellow  skin,  dull  eyes,  the 
poison  gets  into  the  muscles,  they  become  flabby  and  you  feel  weary 
and  worn  out.  It  gets  into  the  nerves,  causing  sleeplessness,  sciatica, 
and  all  nervous  diseases.  All  the  food  taken  into  the  stomach  is 
filtered  by  the  liver  before  it  is  absorbed.  AU  impurities  in  food,  and 
such  as  are  in  poor  whiskey  and  tobacco,  are  filtered  by  the  liver  before 
passing  into  the  general  circulation;  for  instance,  if  whiskey  when 
drank  could  immediately  go  to  the  brain  without  first  being  filtered 
through  the  liver,  the  drinker  would  fall  dead  soon  after  taking  it. 

A healthy  liver  full  of  '‘glycogen”  (animal  starch)  made  from  the 
blood  will  destroy  all  poisons,  but  a poor  and  abused  liver  cannot 
do  this;  therefore,  look  well  to  your  liver  and  keep  it  strong  and 
healthful  by  good  nourishing  food,  well  cooked,  well  chewed,  and  at 
regular  times  of  day  for  your  meals. 

The  kidneys,  as  we  said  before,  are  one  of  the  open  doors  through 
which  part  of  the  dead  matter  filtered  through  the  liver  is  thrown  out 
of  the  body  through  the  urine  (water) ; therefore  keep  the  kidneys  well 
flushed  with  pure  water,  drunk  between  meals,  never  with  the  meals. 
Every  person  should  drink  at  least  six  glasses  of  water  every  24  hours. 

The  bowels  are  the  other  open  door  through  which  the  bulk  of  the 
waste  matter  passes  from  the  body.  They  should  be  kept  clear  at 
regular  intervals;  the  best  time  is  in  the  morning  immediately  after 
breakfast. 

As  about  nine  tenths  of  the  diseases  flesh  is  heir  to  are  caused 
by  ignorant  or  wilful  abuse  of  the  stomach  and  liver,  every  person 
should  make  it  their  business  to  study  themselves,  their  habits  and 
appetites;  and  if  VTong,  correct  them  as  far  as  possible,  for  good 
health  is  far  better  than  riches. 

We  advise  you  to  read  carefully  the  chapter  in  this  book  on  Anat- 
omy and  on  Hygiene;  it  will  help  you  to  keep  yourself  and  family 
well,  and  we  cannot  urge  you  too  strenuously  to  study  this  book  and 
make  yourself  familiar  with  it,  so  when  sickness  comes,  as  it  surely 
will,  you  will  find  these  articles  on  different  diseases,  which  are  all 
written  by  practicing  physicians  and  specialists,  will  enable  you  to 
diagnose  the  case  almost  immediately,  often  saving  long  and  pro- 
tracted sickness  and  perhaps  a cherished  life. 

We  have  scores  of  letters  from  fathers  and  mothers,  even  from 
physicians  (who  are  strangers  to  us)  from  all  parts  of  the  country^ 
speaking  in  the  highest  terms  of  this  book  and  thanking  us  for  the 
valuable  advice  and  information  received  from  it. 

Therefore,  study  it;  you  will  find  it  the  best  friend  you  ever  had 
and  sometime  we  believe  you  will,  say  as  many  others  do,  "It’s  worth 
its  weight  in  gold.” 


ANATOMY 


Unotu 


Every  person  should  know  themselves  physically;  therefore  read 
carefully  the  following:  chapters — first,  on  Anatomy;  second, 
on  Hygiene — which  are  not  only  instructive,  but 
interesting,  and  will  assist  very  materially 
in  avoiding  and  preventing  disease. 


ANATOMY, 


Anatomy  describes  tbe  structure  and  organization  of  living  be- 
ings. 

Special  Anatomy  treats  of  the  weight,  size,  shape,  color,  etc.,  of 
each  organ  separately. 

General  Anatomy  investigates  the  tissues  or  structures  from  which 
organs  are  formed. 

Surgical  Anatomy  or  Regional  Anatomy  considers  the  relations  of 
organs  to  one  another. 

Physiological  Anatomy  treats  of  the  uses  or  functions  of  organs  in 
health. 

Pathological  Anatomy  describes  the  alterations  made  upon  dif- 
ferent organs  by  disease. 

We  shall  here  introduce  a very  brief  compendium  only  of  Special 
Anatomy. 

It  is  of  great  consequence  that  every  person  should  have  some 
knowledge  of  anatomy  and  physiology.  Self-knowledge  ought  to 
extend  to  the  body  as  well  as  the  mind.  To  know  one’s  self,  physi- 
cally, is  to  gain  a new  insight  into  that  wonderfully  skilful  adjust- 
ment of  means  to  ends  which  is  never  absent  from  the  works  of  God. 
Without  tills  knowledge,  one  cannot  know  how  to  take  care  of  the 
health ; and  without  health,  life  loses  most  of  its  value. 

Structure  of  the  Body. 

The  human  body  is  composed  of  solids  and  fluids. 

The  fluids  are  most  abundant  in  children  and  youth.  It  is  this 
wliich  gives  softness  and  pliancy  to  their  flesh.  In  old  age  the  fluids 
are  less  abundant,  and  the  flesh  is  more  hard  and  wrinkled. 

The  fluids  contain  the  whole  body,  as  it  were,  in  a state  of  solu- 
tion ; or  rather,  they  hold  the  materials  out  of  which  it  is  manufac- 
tured. 

Chemical  Properties  of  the  Body. 

The  four  elements,  oxygen,  hydrogen,  carbon,  and  nitrogen,  make 
up  nearly  the  whole  bulk  of  the  fluids  and  soft  solids  of  the  human 
body.  A number  of  other  elements,  chiefly  in  a state  of  combina- 
tion, and  in  much  smaller  quantities,  enter  into  several  of  the  tissues. 

Binary  Compounds.  — Thus,  we  have  carbonic  acid  in  blood,  urine 
and  sweat ; and  we  have  water  universally  diffused  through  the  sys- 
tem, — each  of  these  substances  being  a binary  compound,  that  is, 
composed  of  two  elements. 

Compounds  of  more  than  two  Element.?  are  widely  distributed 
over  the  body ; as. 


1(5 


ANATOMY, 


17 


Carbonate  of  Soda  in  serum,  saliva,  bile,  mucus,  sweat,  and  tears. 

Carbonate  of  Lime  in  cartilage,  bone,  and  teeth. 

Phosphate  of  Lime  in  bones,  teeth,  and  cartilage. 

Phosphate  of  Iron  in  blood,  gastric  juice,  and  urine. 

Chloride  of  Sodium  in  blood,  brain,  muscle,  bone,  cartilage  and 
pigment. 

Chloride  of  Potassium  in  blood,  gastric  juice,  milk,  and  saliva. 

Chloride  -of  Calcium  in  gastric  juice. 

Sulphate  of  Potassa  in  urine,  gastric  juice,  and  cartilage. 

Sulphate  of  Soda  in  sweat,  bile,  and  cartilage. 

Sulphate  of  Lime  in  bile,  hair,  and  scarf-skin. 

Oxide  of  Iron  in  blood,  black  pigment,  and  hair. 

Organized  Compounds.  — Besides  the  above  inorganic  elements 
and  compounds,  several  organized  substances,  or  proximate  elements,  as 
they  are  called,  exist  largely  in  the  body.  The  chief  of  these  are 
albumen,  fibrin,  gelatin,  mucus,  fat,  and  casein.  Others  need  not  be 
named. 

Albumen  is  found  in  great  abundance  in  the  human  body.  It  is 
the  raw  material  out  of  which  the  fiesh  and  other  tissues  are  made. 
The  white  of  an  egg,  which  is  nearly  pure  albumen,  is  a good  speci- 
men of  it. 

Fibrin,  when  removed  from  the  human  body,  changes  from  a solu- 
ble to  an  insoluble  state.  In  other  words,  it  coagulates  in  a kind  of 
net-work.  Nearly  the  same  thing  takes  place  constantly  in  the  living 
body,  when  the  liquid  fibrin  leaves  its  soluble  state,  and  is  deposited 
as  solid  flesh.  Fibrin  bears  the  same  relation  to  albumen  that  wool- 
len yarn  does  to  wool ; it  is  spun  from  it  in  the  busy  wheel  of  or- 
ganic life.  And  the  flesh  or  muscle  is  related  to  fibrin  as  the  cloth 
is  to  yarn  ; it  is  woven  from  it  in  the  vital  loom.  Fibrin  has  been 
called  liquid  flesh. 

Gelatin  exists  largely  in  the  ligaments,  cartilages,  bones,  skin,  and 
cellular  tissue.  When  dissolved,  five  parts  in  one  hundred  of  hot 
water,  it  forms  a thick  jelly.  Isinglass  is  a form  of  gelatin  obtained 
from  the  air-bladder  of  the  sturgeon  and  the  codfish.  Glue  is  still 
another  form  of  gelatin.  It  is  extracted  from  the  bones,  and  parings 
of  hides,  and  the  hoofs  and  ears  of  cattle,  by  boiling  in  water.  Black 
silk,  varnished  over  with  a solution  of  gelatin,  forms  court-plaster. 

Mucus  is  a sticky  fluid  secreted  by  the  gland-cells.  It  is  spread 
over  the  surface  of  the  mucous  membranes,  and  serves  to  moisten  and 
defend  them  from  injury. 

Fat  consists  of  cells  held  together  by  cellular  tissue  and  vessels, 
and  contains  glycerin,  stearic  acid,  margaric  acid,  and  oleic  acid.  It 
has  no  nitrogen.  If  the  stearic  acid  be  in  excess,  the  fat  is  hard ; if 
the  oleic  acid  preponderate,  it  is  soft.  The  stearine  extracted  from 
fat  is  used  for  making  very  hard  candles. 


18 


ANATOMY. 


Casein  is  abundant  in  milk  and  constitutes  its  curd.  It  is  held 
in  solution  in  milk  by  a little  soda.  When  dried,  it  is  cheese.  It  is 
found  in  blood,  saliva,  bile,  and  the  lens  of  the  eye.  It  forms  the 
chief  nourishment  of  those  young  animals  which  live  on  milk.  It  is 
found  in  peas,  beans,  and  lentils.  Vegetable  and  animal  casein  are 
precisely  alike  in  all  their  properties.  Fibrin  and  albumen  contain 
almost  exactly  the  same  amount  of  oxygen,  hydrogen,  carbon,  nitro- 
gen, and  sulphur,  which  is  found  in  casein.  This  latter,  when  taken 
into  the  stomach,  therefore,  goes,  without  much  change,  to  the  forma- 
tion of  the  albumen  and  fibrin  of  the  body. 

Physical  Properties  of  the  Body. 

The  Tissues. — The  solid  organized  substances  of  which  the  human 
body  is  composed,  are  called  tissues.  There  are  various  kinds  of  tissues. 

The  Cellular  Tissue,  commonly  called  areolar,  is  made  up  of  small 
fibres  and  bands  woven  together  into  a sort  of  net-work,  with  numer- 
ous little  spaces  opening  into  each  other.  These  spaces  are  filled  with 
a watery  fluid ; and  when  tliis  is  greatly  increased  by  disease,  so  as 
to  cause  the  parts  to  swell,  and  the  skin  to  shine,  the  person  has  ana- 
sarca, or  cell-dropsy.  The  uses  of  this  tissue  are  to  give  parts  and 
organs  a kind  of  elastic  cushion  to  rest  upon,  so  that  they  may  not  be 
bruised  and  injured  by  the  shocks  of  life ; to  make  a kind  of  safe 
highway  for  delicate  vessels  to  pass  from  one  part  of  the  body  to 
another ; and  to  furnish  a beautifully  arranged  lodgment  for  the  wa- 
tery fluid  which  gives  such  roundness,  smoothness,  and  grace  to  the 
human  form.  The  opening  of  the  cells  into  each  other  explains  the 
reason  why  feeble  persons  have  swelled  feet  and  ankles  in  the  even- 
ing, and  not  in  the  morning — the  fluid  settling  down  from  cell  to  cell, 
into  the  lowest  parts,  while  they  are  up  during  the  day,  and  running 
back  to  its  proper  place  while  they  are  lying  down  during  the  night. 

The  Mucous  Tissue,  or  mucous  membrane,  lines  all  the  cavities 
which  communicate  with  the  air,  as  the  mouth,  stomach,  bowels,  lungs, 
etc.  It  is  supplied  with  numerous  small  glands  which  secrete  a 
sticky  kind  of  fluid  called  mucus,  to  protect  the  surface  from  any 
injury  which  might  be  inflicted  by  air,  or  by  irritating  substances 
suspended  in  it. 

The  Serous  Tissue,  or  membrane,  lines  all  the  cavities  which  do  not 
communicate  with  the  air,  that  is,  all  those  which  are  shut,  and  have 
no  outward  opening.  The  skull,  the  chest,  and  the  belly  are  lined  by 
this  kind  of  membrane.  The  membrane  itself  forms  a closed  sac, 
— one  layer  of  it  being  attached  to  the  cavity  it  lines,  while  the  other 
is  folded  back  upon  and  around  the  contents  of  the  cavity,  which  are 
left  outside  of  the  sac.  A watery  fluid  oozes  from  the  inner  surface 
of  the  sac,  to  make  its  sides  glide  easily  upon  each  other.  When 
some  disease  causes  this  water  to  be  poured  out  too  freely,  so  as  to 
fill  or  partly  fill  the  cavity,  we  have  dropsy  of  the  brain,  or  chest,  or 
abdomen,  as  the  case  may  be. 


ANATOMY. 


19 


The  Dermoid  Tissue  covers  the  whole  outside  of  the  body.  We 
call  it  the  skin,  or  cutis.  It  is  similiar  in  structure  to  the  mucous 
membranes,  which  are  a mere  continuation  of  it.  It  is  harder  than 
the  mucous  membrane,  because  more  exposed  to  injury.  In  health, 
it  never  ceases  to  secrete  and  throw  off  a fluid  which  we  call  insen- 
sible perspiration  while  it  is  in  the  form  of  an  invisible  vapor,  and 
perspiration,  or  sweat,  when  it  is  so  increased  as  to  be  seen.  So 
great  is  the  sympathy  between  this  dermoid  covering  of  the  body 
and  the  mucous  membranes,  that  when  it  is  chilled  so  as  to  stop  the 
invisible  perspiration,  the  internal  membrane  becomes  affected,  and 
we  have  a sore  throat,  or  diarrhoea,  or  running  at  the  nose ; that  is 
to  say,  when  the  skin  cannot  sweat,  the  mucous  membrane  begins  to 
sweat. 

The  Fibrous  Tissue  consists  of  closely  united  fibres,  and  for  what- 
ever purpose  used,  forms  a fine,  dense,  and  enduring  body.  In  some 
cases  it  takes  the  form  of  a membrane,  as  the  dura  mater,  which  lines 
the  interior  of  the  skull  and  spinal  column.  The  ligaments  which 
hold  the  bones  together,  and  the  tendons  or  cords,  which  fasten  the 
muscles  to  the  bones,  are  fibrous  bodies.  It  is  this  firm  substance  of 
which  rheumatism  frequently  takes  hold,  and  this  is  the  reason  why 
it  lingers  so  much  about  the  joints.  It  sometimes  takes  hold  of  the 
ligament  which  fastens  the  deltoid  muscle  to  the  bone  of  the  upper 
arm,  about  two-thirds  of  the  way  from  the  elbow  to  the  shoulder. 
This  muscle  lifts  up  the  arm.  In  this  form  of  rheumatism,  therefore, 
the  arm  hangs  helpless  at  the  side. 

The  Cartilaginous  Tissue  covers  the  ends  of  the  bones  where  they 
come  together  to  make  a joint.  It  is  well  fitted  to  make  the  joint 
work  easy,  being  smooth,  hard,  and  elastic. 

The  Osseous  or  Bony  Tissue  varies  in  its  composition,  density, 
and  strength,  according  to  the  age  of  the  person,  and  the  uses  of  the 
bone. 

The  Muscular  Tissue,  or  muscle,  being  made  for  a great  deal  of 
pulling  and  lifting,  is  formed  something  like  a rope,  except  that 
there  is  no  twisting.  Many  small 
fibres  or  filaments  unite  to  form 
fasciculi.  A fasciculus  is  a bundle 
of  fibres  surrounded  by  a delicate 
layer  of  cell-tissue  called  sarcolemma, 

— just  as  a cord  is  a number  of 
smaller  threads  of  cotton  or  hemp 
bound  together.  A number  of  these 
fasciculi  united  together  make  a 
muscle,  — just  as  several  cords,  called 
strands,  twisted  together,  make  a fiq.  l 

rope.  Figure  1 gives  us  a good  view  of  the  fibres  and  bundles, 
highly  magnified. 


20 


ANATOMY. 


The  Adipose  Tissue  is  tlie  material  which  the  human  body  works 
up  into  pots  and  cells  containing It  is  found  chiefly  under  the 
skin  and  muscles  of  the  belly,  and  around  the  heart  and  kidneys. 
By  the  increase  of  tliis  tissue,  persons  may  become  enormously  en- 
larged without  having  their  muscles  at  all  increased  in  size.  Such  a 
condition  is  to  be  deplored,  — the  body  having  become  merely  the 
storehouse  or  depot  of  myriads  of  pots  of  fat. 

The  Nervous  Tissue  is  composed  of  two  distinct  kinds  of  matter, 
— the  one  gray  and  pulpy,  called  cineritious^  the  other  white  and 
fibrous,  called  medullary.  The  external  part  of  the  brain  and  the  in- 
ternal portion  of  the  spinal  cord  are  composed  of  the  gray  or  ash- 
colored  tissue ; the  nerves  are  made  only  of  the  white  or  fibrous 
matter,  and  are  inclosed  in  a delicate  sheath  called  neurilemma. 

Vital  Properties  of  the  Body. 

Bodies  begin  their  growth  with  a simple  cell.,  which  is  a delicate 
little  bladder  or  shut  sac.  Cells  take  their  rise  in  that  portion  of 
the  blood  which  is  capable  of  being  organized,  and  which  is  called 
blastema. 

In  animal  bodies  each  cell  generally  begins  as  a minute  point  in 
the  blastema,  and  grows  until  a transparent  bladder  or  vesicle  springs 
out  from  one  side  of  it,  and  soon  appears  to  enclose  it.  The  bladder 
is  then  called  the  cell,  and  the  point  or  dot  is  its  nucleus.  Within 
this  nucleus  appears  another  dot,  wluch  is  called  the  nucleolus. 
When  fully  ripened,  the  cell  bursts  and  sets  the  nucleus  free,  and 
this,  in  its  turn,  matures  and  yields  up  its  contents.  Thus  all  cells 
have  their  origin  in  germs  produced  by  previously  existing  parent- 
cells.  They  are  multiplied  with  great  rapidity.  Having  grown  to 
a certain  extent,  they  lose  their  fluid  contents,  and  their  walls  col- 
lapsing or  coming  together,  they  form  simple  membraneous  discs. 
In  this  way,  with  some  variations,  the  simple  tissvies  of  the  body  be- 
gin to  be,  and  the  foundation  is  laid  for  the  noble  structure  of  man. 

Anatomy  of  the  Bones. 

The  human  skeleton  is  composed  of  two  hundred  and  eight  bones, 
the  teeth  not  included. 

When  fastened  together  by  natural  ligaments,  the  bones  are  said 
to  form  a natural  sk^h*^;  when  attached  by  wires,  an  artificial  skele- 
ton. 

In  Figure  2,  — 1,  1,  represent  the  spinal  column  ; 2,  the  skull ; 3, 
the  lower  jaw ; 4,  the  breast-bone  (sternum)  ; 6,  the  ribs ; 7,  the  col- 
lar-bone ; 8,  the  bone  of  the  upper  arm  (humerus)  ; 9,  the  shoulder- 
joint;  10,  the  radius;  11,  the  ulna;  12,  the  elbow-joint;  13,  the 
wrist;  14,  the  hand;  15,  the  haunch-bone;  16,  the  sacrum;  17,  the 
hip-joint ; 18,  the  thigh-bone  ; 19,  the  knee-cap  (patella) ; 20,  the 
knee-joint ; 21,  the  fibula ; 22,  the  tibia ; 23,  ankle-joint ; 24,  the 
foot ; 27,  28,  29,  th«  tlxyaments  of  the  shoulder,  elbow,  and  wrist  •• 


3 


22 


ANATOMY. 


30,  the  large  artery  of  the  arm;  31,  the  ligaments  of  tne  hip-joint; 
32,  the  large  blood-vessels  of  the  thigh ; 33,  the  artery  of  the  leg ; 
34,  35,  36,  the  ligaments  of  the  knee-cap,  knee,  and  ankle. 

The  protuberances  or  swellings  in  certain  parts  of  the  bones  are 
called  processes,  and  are  the  points  to  which  muscles  and  ligaments 
are  fastened. 

The  bones  are  supplied  with  nutritive  vessels,  and,  like  other  parts 
of  the  body,  are  formed  from  the  blood.  At  first  they  are  compara- 
tively soft  and  cartilaginous.  After  a time,  in  the  young  animal, 
they  begin  to  change  to  bone  at  certain  places,  called  points  of  ossifi- 
cation. They  are  covered  with  a strong,  fibrous  membrane  called  the 
periosteum.  A somewhat  similar  covering  upon  the  cartilages  has 
the  name  of  perichondrium.,  and  that  which  covers  the  skull  is  the 
pericranium. 

The  bones  are  compounded  of  earthy  and  animal  matter.  From 
the  former  — phosphate  and  carbonate  of  lime  — they  receive  their 
strength ; from  the  latter  — cartilage  — they  derive  their  life. 

Put  a bone  for  a few  days  into  diluted  muriatic  acid,  — one  part 
of  acid  to  six  of  water,  — and  the  phosphate  and  carbonate  of  lime 

will  all  be  removed,  while 
the  bone  will  remain  the  ^ 
same  in  shape.  It  will  now 
be  comparatively  soft,  and 
may  be  bent,  or  even  tied 
into  a knot  without  break- 
ing. Place  a similar  bone 
in  the  fire  for  a few  hours, 
and  it  will  also  retain  its 
shape,  but  the  cartilaginous 
portion  will  be  gone.  It  is 
now  brittle,  and  may  be 

The  bones  are  divided  into  those  of  the  head,  thirty  ; of  the  body, 
fifty-four;  of  the  upper  limbs,  sixty-four;  and  of  the  lower  limbs, 
sixty. 


Fig.  3. 

picked  in  pieces  with  the  fingers. 


Bones  of  the  Head. 

The  bones  of  the  head  are  divided  into  those  of  the  slcull,  the  ear, 
and  the /ace. 

The  skull  has  eight  bones.  They  are  composed  of  two  plates,  one 
above  the  other,  with  a porous  partition  between.  These  two  plates 
are  capable  of  giving  the  brain  very  powerful  protection  against  in- 
jury, the  outer  one  being  fibrous  and  tough,  — the  inner  one,  hard 
and  glass-like,  and  hence  called  vitreous. 

The  middle  layer  has  the  name  of  diploe.  Its  spongy  nature 
deadens  the  jar  from  a blow  inflicted  upon  the  outer  table.  In  early 
life,  when  the  bones  are  tender  and  yielding,  this  porous  layer  is  not 
needed,  and  is  not  found. 


ANATOMY. 


23 


That  the  hones  of  the  skull  may  not  easily  slip  by  each  other,  and 
get  out  of  place,  they  are  dovetailed  together  in  curious  lines  called 
sutures.  In  advanced  years,  these  gen- 
erally close  up,  the  bones  uniting  firmly 
together.  In  early  life  they  are  quite 
open,  the  firm  bones  not  covering  the 
whole  brain.  The  opening  of  the 
coronal  suture  in  childhood  is  called  a 
fontaneUe.  It  presents  a soft  place 
upon  the  top  of  the  head,  where  the 
finger  could  be  pressed  down  into  the 
brain.  In  Figure  4,  — 1,  1,  show  the 
coronal  suture  on  the  front  and  upper 
part  of  the  skull ; 2,  the  sagittal  suture 
on  the  top  of  the  skull ; and  3,  3,  the 
lambdoidal  suture,  running  down  on 
each  side  of  the  back  part  of  the  skull. 

Figure  5 shows  the  skull-bones  separated  from  each  other  at  the 
sutures  : 1,  the  frontal  bone  ; 2,  the  parietal ; 2,  the  occipital : 4,  the 
temporal ; 5,  the  nasal ; 6,  the  malar ; 7,  the  superior  maxillary ; 8, 

the  unguis ; 9,  the  in- 
ferior maxillary.  Ar- 
nott  has  demonstrated 
that  the  form  of  the 
skull  is  the  best  possible 
for  sustaining  wei 
and  resisting  blows.  The 
summit  of  the  head  is  a 
complete  arch,  like  that 
of  a bridge. 

The  ear  has  four 
small  bones,  which  aid 
the  sense  of  hearing. 

The  bones  of  the  face 
are  fourteen  in  number. 
They  hold  the  soft  parts 
in  place,  and  aid  in 
grinding  the  food. 

Bones  of  the  Trunk. 

In  the  trunk  there  are  twenty-four  ribs  ; twenty-four  pieces  in  the 
backbone  or  spinal  column ; four  bones  in  the  pelvis  and  hips  ; one 
breast-bone,  called  sternum ; and  a bone  at  the  base  of  the  tongue, 
called  os  hyoides.  They  are  so  put  together  as  to  form  two  great 
cavities,  namely,  the  thorax  or  chest,  and  the  abdomen  or  belly. 

The  ribs,  connecting  with  the  backbone  behind  and  the  breast-bone 
in  front,  form  the  thorax,  which  contains  the  lungs  and  heart.  Fig. 


Fig.  4. 


24 


ANATOMY. 


6 shows  the  natural  form  of  the  healthy  chest : 1,  is  the  spine  ; 2,  2, 
the  collar-bones ; 3,  3,  the  seven  upper,  or  true  ribs ; 4,  4,  the  five 
lower  or  false  ribs ; 6,  the  breast-bone,  to  winch  the  true  ribs  are 

united ; 6,  the  sword-shaped 
cartilage  which  constitutes  the 
lower  end  of  the  breast-bone, 
called  ensiform  cartilage;  7,  7, 
the  upper  part  of  two  lungs  ; 8, 
8,  the  right  lung,  seen  between 
the  ribs  ; 9,  9,  the  left  lung  ; 10, 
10,  the  heart;  11,  11,  the  dia- 
plu’agm,  or  midriff;  12,  12,  the 
liver ; 13,  13,  the  stomach,  14, 
14,  the  second  stomach,  or 
duodenum ; 15,  the  transverse 
colon ; 16,  the  upper  part  of  the 
colon  on  right  side;  17,  upper 
part  of  colon  on  left  side. 

Each  piece  of  the  spinal  col- 
umn is  called  a vertebra.  Upon 
every  one  of  these  are  seven 
projections,  called  processes  — a part  of  which  are  for  linking  the 
bones  together,  and  the  rest  to  furnish 
attachments  for  the  muscles  of  the  back. 

The  projections  are  linked  together  in 
such  a way,  that  a continuous  channel  or 
opening  runs  down  through  the  whole, 
in  which  is  lodged  the  spinal  cord,  or 
medulla  spinalis.  This  nervous  cord  is 
connected  with  the  base  of  the  brain,  and 
is  a kind  of  continuation  of  it. 

Between  all  the  vertebrse  are  certain 
cartilaginous  cushions,  which,  when  com- 
pressed, spring  back,  like  India  rubber, 
and  thus  protect  the  brain  from  being  injuriously  jarred  by  running, 

leaping,  or  walking. 

The  pelvis  has  four  bones  : 
the  two  nameless  bones  — in- 
nominata.,  the  sacrum,  and  the 
coccyx.  In  the  side  of  each  of 
the  nameless  bones  is  a deep, 
smooth  cavity,  called  the  ace- 
tabulum. Into  this  the  round 
head  of  the  thigh-bone  is  nicely 
fitted.  When  the  bone  is 
tlirown  out  of  this  cavity,  the 
hip  is  said  to  be  out  of  joint. 
The  sacrum  took  its  name 


Fig.  8. 


ANATOMY. 


25 


from  the  fact  that  the  heathens  used  to  offer  it  in  sacrifice.  With 
them,  it  was  the  sacred  bone.  The  coccyx  is  the  lower  termination 
of  the  backbone.  These  bones  are  represented  in  Fig.  8 : 1,  1,  being 
the  innominata ; 2,  the  sacrum ; 3,  the  coccyx  ; 4,  4,  the  acetabulum : 
a,  a,  the  pubic  portion  of  the  nameless  bones ; d,  the  arch  of  the 
pubes ; e,  the  union  of  the  sacrum  and  the  lower  end  of  the  spinal 
column. 


Bones  of  the  Upper  Extremities. 

The  shoulder-blade  (scapula),  the  collar-bone  (clavicle),  the  bone  of 
the  upper  arm  (humerus),  the  two  bones  of  the  forearm  (ulna  and  ra- 
dius), the  bones  of  the  wrist  (carpal  bones),  the  bones  of  the 
\ palms  of  the  hand  (metacarpal  bones),  the  bones  of  the 
thumb  and  fingers  (phalanges),  — these  are  the  bones  of 
the  upper  limbs. 

The  collar-bone  is  fastened  at  one  end  to  the  breast-bone, 
at  the  other  end  to  the  shoulder-blade.  It  keeps  the  shoul- 
ders from  dropping  forward.  Many  persons  allow  it  to  fail 
of  this  end  by  getting  very  much  bent  in  early  life.  This 
happens  at  school,  when  children  are  allowed  to  sit  in  a 
stooping  posture.  In  the  French,  a race  re- 
markable for  a straight,  upright  figure,  this 
bone  is  said  to  be  longer  than  in  any  other 
people. 

The  shoulder-blade  lies  upon  the  upper  part 
of  the  back,  forming  the  shoulder.  It  has  a 
shallow  cavity  (glenoid  cavity),  into  which  is 
inserted  the  head  of  the  upper  arm-bone.  Sev- 
eral strong  muscles  are  attached  to  the  eleva- 
tions of  this  bone,  which  keep  it  in  its  place, 
and  move  it  about  as  circumstances  require. 

The  upper  arm-bone  has  its  round  head  fast- 
ened in  the  glenoid  cavity,  by  the  strong  capsular  liga- 
ment, forming  a joint  capable  of  a great  number  of  move- 
ments. At  the  elbow  it  is  united  with  the  ulna  of  the 
fore-arm.  It  is  a long,  cylindrical  bone,  represented  by 
Fig.  9 : 1,  is  the  shaft  of  the  bone  ; 2,  the  large,  round ; 
head  which  fits  into  the  glenoid  cavity;  3,  the  surface! 
which  unites  with  the  ulna. 

Of  the  two  bones  of  the  fore-arm,  the  ulna  is  on  the  inner  side,  and 
unites  with  the  humerus,  making  an  excellent  hinge-joint.  The 
other  bone  of  the  fore-arm,  the  radius,  lies  on  the  outside  of  the  arm, 
— on  the  same  side  with  the  thumb,  — and  unites,  or  articulates,  as 
we  say,  with  the  bones  of  the  wrist.  In  Fig.  10 : 1,  is  the  body  of 
the  ulna ; 2,  the  shaft  of  the  radius ; 4,  the  articulating  surface,  with 
which  the  lower  end  of  the  humerus  unites ; 5,  the  upper  extremity 
of  the  ulna,  called  the  olecranon  process,  which  forms  the  elbow- 
joint;  6,  the  point  where  the  ulna  articulates  with  the  wrist. 


Pig.  9. 


Fig.  10. 


26 


ANATOMY. 


The  eight  bones  of  the  wrist  or  carpus  are  ranged  in  two  rows,  and 
being  bound  close  together,  do  not  admit  of 
very  free  motion.  In  Fig.  11 : s,  is  the  scaphoid 
bone ; L,  the  semilunar  bone ; c,  the  cuneiform 
bone ; P,  the  pisiform  bone  ; T,  T,  the  trapezium 
and  trapezoid  bones  ; M,  the  os  magnum ; u,  the 
cuneiform  bone.  The  last  four  form  the  sec- 
ond row  of  carpal  bones.  11,  11,  are  the  meta- 
I carpal  bones  of  the  hand ; 2,  2,  the  first  range 
of  the  finger-bones ; 3,  3,  the  second  range  of 
i finger-bones ; 4,  4,  the  third  range  of  finger- 
bones  ; 5,  6,  the  bones  of  the  thumb. 

Of  the  five  metacarpal  bones,  four  are  at- 
tached below  to  the  first  range  of  the  finger- 
bones,  and  the  other  to  the  first  bone  of  the 
thumb,  while  the  whole  are  united  to  the  second 
Fig.  11.  range  of  the  carpal  bones  above. 


Bones  of  the  Lower  Extremities. 

These  are  the  thigh-hone  (femur),  the  Tcnee-pan  (patella),  the  sTiiur 
bone  (tibia),  the  small  hone  of  the  leg  (fibula),  the  hones  of  the  instep 
(tarsal  bones),  the  hones  of  the  middle  of  the  foot  (meta- 
tarsal bones),  and  the  hones  of  the  toes  (phalanges). 

The  thigh-hone  is  the  longest  bone  in  the  system.  Its 
head,  which  is  large  and  round,  fits  admirably  into  the 
cavity  in  the  innominatum,  called  acetabulum,  and  forms 
what  is  called  a ball-and-socket  joint.  In  Fig.  12  : 1,  is 
the  shaft  of  the  thigh-bone  (femur)  ; 2,  is  a projection 
called  the  trochanter  minor,  to  which  some  strong  mus- 
cles are  attached;  3,  is  the  head  of  the  femur,  which  fits 
into  the  acetabulum ; 5,  is  the  external  projection  of  the 
femur,  called  the  external  condyle;  6,  the  internal  con- 
dyle ; 7,  the  surface  which  articulates  with  the  tibia, 
and  on  which  the  patella  slides. 

The  knee-pan  or  knee-cap  (patella)  is  placed  on  the 
front  of  the  knee,  and  being  attached  to  the  tendon  of 
the  extensor  muscles  above,  and  to  the  tibia  by  a strong 
ligament  below,  it  acts  as  a pulley  in  lifting  up  the  leg. 

The  shin-bone  (tibia)  is  the  largest  of  the  two  in  the 
lower  leg,  and  is  considerably  enlarged  at  each  end. 

The  small  bone  of  the  leg  (fibula)  lies  on  the  out- 
side, and  is  bound  to  the  larger  bone  at  both  ends.  Fig./ 

13  shows  the  two  bones  of  the  leg:  1,  being  the  tibia;) 

5,  the  fibula ; 8,  the  space  between  the  two ; 6,  the 
junction  of  the  tibia  and  fibula  at  the  upper  extrem- 
ity ; 3,  the  internal  ankle ; 4,  the  lower  end  of  the  tibia  that  unites 


Fig.  12. 


ANATOMY. 


27 


with  one  of  the  tarsal  bones  to  form  the  ankle-joint ; 7,  the  upper 
end  of  the  tibia,  which  unites  with  the  femur. 

The  instep  (tarsus)  has  seven  bones,  which,  like  those  of  the 
wrist,  are  so  firmly  bound  together  as  to  allow  but  a limited  motion. 

The  metatarsal  bones,  corresponding  with  the  palm  of  the  hand,  are 
five  in  number,  and  unite  at  one  end  with  the  tarsal  bones,  and  at 
the  other  with  the  first  range  of  the  toe-bones. 

The  tarsal  and  metatarsal  bones  are  put  together  in  the  form  of 
an  arch,  the  spring  of  which,  when  the  weight  of  the  body  descends 
upon  it  in  walking,  prevents  injury  to  the  organs  above.  (Fig.  14.) 

The  phalanges  have  fourteen  bones.  The  great  toe  has  two  ranges 


Fig.  13. 


of  bones ; the  other  toes  have  three.  Fig.  15  gives  a view  of  the 
upper  surface  of  the  bones  of  the  foot : 1,  is  the  surface  of  the  as- 
tragalus where  it  unites  with  the  tibia ; 2,  the  body  of  the  astragalus ; 
3,  the  heel-bone  (os  calcis) ; 4,  the  scaphoid  bone ; 6,  6,  7,  the  cune- 
iform bones;  8,  the  cuboid;  9,  9,  9,  the  metatarsal  bones;  10,  the 
first  bone  of  the  great  toe  ; 11,  the  second  bone ; 12,  13,  14,  three 
ranges  of  bones  forming  the  small  toes. 

The  Joints. 

That  bones  may  be  of  any  use,  they  must  be  jointed  together. 
Joints  are  of  the  greatest  importance.  It  is  necessary  they  should  be 
so  constructed  that  there  shall  be  no  harsh  grating  of  the  bones  upon 
each  other,  and  no  injurious  jars  in  walking,  etc.  To  prevent  these 
things,  a hard,  smooth,  and  yet  yielding,  cushion-like  substance  is 


28 


ANATOMY. 


required  between  them  in  joints.  Such  are  the  cartilages.  Fig.  16 
gives  a specimen  of  these  intervening  cartilages.  D,  is  the  body  of 

a bone,  at  the  end  of 
which  is  a socket ; C, 
the  cartilage  lining  the 
socket,  thin  at  the  sides 
and  thick  in  the  centre ; 
B,  the  body  of  a bone,  at 
the  end  of  which  is  a 
round  head  ; C,  the  investing  cartilage,  thin  at  the  sides  and  thick 
in  the  centre. 

Cartilage  grows  thinner,  harder,  and  less  elastic  in  old  age.  Hence 
old  people  are  not  quite  as  tall  as  in  middle  life,  and  a little  stiff er 
in  their  joints. 

The  synovial  membrane  is  a thin  layer  covering  the  cartilage,  and 
being  bent  back  upon  the  inner  surface  of  the  ligaments,  it  forms  a 
closed  sac.  From  its  inner  surface  a sticky  fluid  oozes  out,  which 
helps  the  joints  to  play  easily. 

There  are  other  smaller  sacs  connected  with  the  joints,  called 
bursa  mucosae.  They  secrete  a fluid  similar  to  that  from  the  syno- 
vial membrane. 


Fig.  16. 


The  ligaments.  To  retain  the  bones  in  their  places  at  the  joints, 
some  strong,  flexible  straps  are  required  to  stretch  across  from  one 
to  the  other,  and  to  firmly  unite  them.  Such  are  the  ligaments. 

They  are  the  pearl-colored,  lustrous,  shining  parts  about  the  joints, 
in  the  form  of  straps  and  cords.  There  are  a number  of  them  so 
woven  together  as  to  form  a complete  covering  of  the  joint,  called  a 
capsular  ligament.  In  Fig.  17  : 1,  2,  are  ligaments  extending  from 
the  hip-bone,  6,  to  the  femur,  4.  In  Fig.  18;  1,  is  the  socket  of  the 
hip-joint;  2,  head  of  the  femur,  lodged  in  the  socket;  3,  the  ligament 
within  the  socket.  In  Fig.  19:  1,  is  the  tendon  of  the  muscle  which 
extends  the  leg ; 2,  the  knee-cap  (patella) ; 3,  the  anterior  ligament 


PI.  8. 


MUSCLES  OF  THE  HUMAN  BODY, 


ANATOMY. 


29 


of  the  patella ; 6,  the  long  external  lateral  ligament ; 4,  4,  the  syno- 
vial membrane ; 5,  the  internal  lateral  ligament ; 7,  the  anterior  and 
superior  ligament  that  unites  the  tibia  with  the  fibula. 

Uses  of  the  Bones. 

The  bones  are  to  the  body  what  the  frame  is  to  the  house.  They 
hold  up  and  retain  the  other  parts  in  their  proper  places.  They  fur- 
nish points  of  attachment  for  the  muscles,  to  hold  the  body  together 
and  to  give  it  motion.  They  also  furnish  strong,  bony  cavities  for 
the  lodgment  and  protection  of  such  delicate  organs  as  the  eye,  the 
brain,  and  the  heart. 

A single  bone,  examined  by  itself,  might  not  seem  to  have  much 
beauty  or  design  about  it;  it  might  even  look  clumsy  and  misshapen. 
But  when  all  the  bones  are  inspected  with  reference  to  each  other, 
we  immediately  discover  a general  plan  upon  which  they  are  made, 
and  are  compelled  to  admire  their  beautiful  harmony,  and  the  sym- 
metrical grace  with  which  they  act.  They  show  us  that  God  can 
command  our  wonder,  even  in  the  bony  frame  of  our  bodies. 

The  iTuscles. 

That  part  of  the  animal’s  body  which  we  call  lean  meat  is  com- 
posed of  muscles.  We  have  already  explained  that  muscles  are  com- 
posed of  threads,  etc.,  put  together  in  great  numbers,  forming  bundles. 
So  numerous  are  these  threads  and  bundles  in  some  cases,  that  the 
muscles  which  are  composed  of  them  have  a strength  truly  wonderful. 

Toward  the  end  of  the  muscle,  the  fibres  cease,  and  the  structure 
is  so  modified  as  to  become  a white  cord  of  great  density  and  strength. 
This  cordy  substance  is  fastened  to  the  bone  so  strongly,  that  it  is 
impossible,  except  in  some  rare  cases,  to  detach  it.  Generally  the 
bone  will  sooner  break  than  this  attachment  will  give  way.  Some- 
times this  cord  spreads  out  like  a membrane.  It  is  then  called /asa'a 
or  aponeurosis. 

The  fibres  of  a muscle  have  the  peculiar  property  of  contracting 
under  a nervous  stimulus  sent  to  them  by  the  will.  These  contrac- 
tions cause  them  to  act  as  pulleys,  and  to  move  the  bones,  and  conse- 
quently the  limbs  and  body,  in  such  direction  as  the  will  commands. 
This  is  the  special  use  of  the  muscles.  All  our  movements  are  caused 
by  them.  They  pull  us  about,  not  blindly  and  at  a random,  but 
under  the  direction  of  an  intelligent  will. 

The  manner  in  which  a muscle  acts,  with  the  cord  attached,  may 
be  seen  by  examining  the  leg  or  “ drum-stick  ” of  a fowl.  If  the  cord 
on  one  side  be  pulled,  the  claws  are  shut;  if  that  upon  the  other 
side  be  drawn,  they  will  open.  If  both  be  pulled,  they  are  held  fast 
in  one  position,  neither  opening  nor  shutting. 

An  examination  of  a piece  of  boiled  lean  meat  will  show  the 


30 


ANATOMY. 


threads  of  which  it  is  composed.  With  proper  instruments,  these  may 
be  unravelled,  as  it  were,  until  fibres  will  be  found  not  larger  than  a 
spider’s  web.  These,  covered  with  sheaths  of  great  delicacy,  extend 
beyond  the  fleshy  fibre,  and  with  the  cell-substance  connecting  the 
fibres,  are  condensed  into  tendon. 

Millions  of  these  sheathed  fibres  are  gathered  into  a bundle,  and 
covered  with  a sheath,  and  thus  form  what  is  called  a fasciculus.  A 
muscle  is  a number  of  these  fascicula  made  into  a bundle,  and  cov- 
ered with  a sheath  called  & fascia  (Fig.  1). 

The  arm  is  a number  of  muscles  bundled  together,  and  covered, 
likewise,  by  a fascia. 

The  fibres  in  a fasciculus  being  parallel,  act  together.  But  the 
fasciculous  bundles  which  make  up  a muscle  act  in  various  ways. 

Shape  of  the  Muscles Some  muscles  are  fusiform  or  spindle- 

— shaped,  so  that  the  attachment  occupies  but  a 

" small  space  (Fig.  20). 

FIG.  20.  Other  muscles  are  radiate  or  fan-shaped  (Fig. 

21).  Such  is  the  temporal  muscle,  the  thin 
edge  of  which  is  attached  to  the  side  of  the  head, 
without  producing  an  elevation  or  deformity. 

In  some  cases  the  fasciculi  are  arranged  unon 
one  or  both  sides  of  a tendon.  In  this  way  a 
great  number  may  concentrate  their  action  upon 

a single  point.  Such  muscles  are  called  penni- 
form,  — being  shaped  like  a feather  (Fig.  22). 

In  other  instances,  the  fasciculi  form  circular 
muscles,  — orbiculares,  or  sphincters,  as 
they  are  called.  These  surround  certain  openings  into  the 
body,  which  they  are  designed  to  close,  either  in  whole  or 
in  part.  They  surround  the  eyelids,  the  anus,  the  mouth  fio.  23. 
of  the  womb,  etc.  (Fig.  23). 

In  still  other  instances  the  fasciculi  are  ranged  side  by  side  in 

rings,  forming  muscular 
tubes.  By  the  successive 
contraction  of  these  rings, 
any  substance  is  driven 
through  the  tube,  — as  food  or  drink  through  the  gullet  of  a cow. 
Fig.  24  is  a section  of  the  gullet : a,  b,  show  the  circular  fibres ; 
c,  the  longitudinal. 

Sometimes  the  fasciculi  curve  around  in  parallel  layers  or  inter- 
lace with  each  other,  forming  a bag  or  pouch.  By  the  contraction 
of  these  fasciculi,  the  contents  of  the  bag  will  be  turned  from  side 
to  side  as  in  the  case  of  the  stomach,  or  driven  out,  as  in  that  of  the 
heart.  Fig.  25  shows  the  muscles  of  the  stomach  : L,  represents  the 
fibres  running  in  one  direction  ; c,  in  another ; E,  lower  end  of  gullet 
o,  pylorus  ; D,  beginning  of  duodenum,  or  second  stomach. 


Fig.  24. 


Fig.  22. 


Fig  21 


Brachialis-LiJ 

anticus 


.Rectus,  . 
abdominis 

■External 

obUcjue 

1.= — Tensor  fasciae 
I femoris 

^ — Pectineus 


__ . . Sterna  - deldd^ mastoid 
Trapezius 

- - - -Deltoid  (or  shoulder) 
-—Pedorah's  major 


^..Extensor  carpi 
‘ radial  IS 

Extensor' . 
communis 
digitorum 


Flexor  carpi  — 


umans 


flexor  carpi-. 


radiah's 


Biceps i 


{or  front  arnf 


Triceps 


(or  back  arm) 


Laiissimus  dors! 


Serratus  majnus 


Sartonus 


Rectus  femons 


-Adductor  hnqus 


Mastus  externus 


Vastus  mternus 


Patella  (or  knee  pan) 


Tibia  (or  shm  bone)- 


flnnu/ar  Ligament 


i— Gastrocnemius  (or  calf) 

- Tibialis  anticus 
...  Flexor  hn^us  di^itorum 

- -—-Extensor  lon^us  dijiforum 


The  Muscles  of  the  Human  Body. 


COPYRIGHT  190S. 


PHYSICIANS  PUBLISHING  CO.,  BOSTON,  MASS, 


I 


Sterno  -fnastoid 
Sp/emus  capitis 

Trapezius  ■" 


Triceps 


Txtensor  carp! _ 
radial  is  long  tor 
Extensor  carpi 
radiaUs  breviorr 
Extensor  communis 
di^itorum 


Gluteus  rnedius  — '' 

Biceps 
Semi-  tenJinosus  - ■ 
Semi -membranosus 


Supinator 

lor.^us 


Posterior  portion  of  external  oblhjue 


- Triceps 
Deltoid 


Teres  minor 
Teres  major 
Infraspinatus 


Latissimus  dorsi 


— Gluteus  maximus 


Vastus  externus 


$oleus—{_ 


_)-•  Gastrocnemius 


Tendon  achillis 


The  Muscles  of  the  Human  Body. 


COPYRIGHT  190&*. 


PHYSICIANS  PUBLISHING  CO.,  BOSTON,  MASS. 


ANATOMY. 


33 


Number  of  Muscles.  — The  muscles  of  the  body  are  as  numerous 
as  the  ropes  of  a ship,  — there  being  five  hundred  or  more.  Some 
anatomists  reckon  more,  some  less. 

They  are  divided  into  those  of  the  head  and  nech^  those  of  the 
trunk,  those  of  the  upper  extremities,  and  those  of  the  lower  extremi< 
ties. 

They  are  too  numerous  to  be  named  and  individually  described  in 
this  brief  account  of  them.  A part  of  them  are  voluntary,  that  is, 
under  the  control  of  the  will ; 
while  another  part  are  involun- 
tary, moving  without  reference  to 
the  will.  The  heart  is  of  the 
latter  kind,  it  being  necessary  for 
it  to  keep  moving  when  the  will 
and  mind  are  asleep. 

On  the  back  there  are  six 
layers  of  muscles,  one  above  an- 
other. Such  a number  are  neces- 
sary to  perform  the  numerous 
movements  of  the  back,  neck, 
arms,  etc.  Every  expression  of  the  human  face,  as  joy,  sorrow,  love, 
hate,  hope,  fear,  etc.,  is  produced  by  the  gentle  pulling  of  muscles, 
made  expressly  to  indicate  these  emotions. 

The  diaphragm  is  a large  fiat  muscle,  reaching  across  the  great 
cavity  of  the  body,  and  dividing  the  chest  from  the  abdomen.  It  is 
penetrated  by  the  gullet  going  to  the  stomach,  and  by  the  great 
blood-vessels  leading  to  and  from  the  heart.  It  is  shaped  like  the 
cover  of  a dinner-dish,  the  convex  surface  being  turned  up.  When 
the  breath  is  drawn  in,  it  sinks  down  towards  a level,  thus  enlarging 
the  chest  at  the  expense  of  the  belly.  When  the  breath  is  thrown 
out,  the  reverse  takes  place. 

Mode  of  Action. — The  contractibility  of  a muscle,  of  which  I have 
spoken,  is  simply  its  power  of  shortening  itself.  The  hand  is  raised 

by  the  shortening  of  a mus- 
cle in  front,  attaehed  to  the 
bone  above  the  elbow,  and 
to  a bone  below  the  elbow. 
The  contraction  of  an  an- 
tagonistic muscle  behind, 
also  attached  above  and  be- 
low the  elbow,  brings  the 
hand  back  to  its  place.  Fig. 
26  shows  how  all  joints  are 
moved : 1,  is  the  bone  of  the  arm  above  the  elbow ; 2,  one  of  the 
bones  below  the  elbow;  3,  the  muscle  which  bends  the  elbow;  4,  5, 
attachments  of  museles  to  bones  ; 6,  the  muscle  that  extends  the 


34 


ANATOMY. 


elbow;  7,  attachment  to  elbow;  8,  weight  in  hand.  The  muscle,  8, 
contracts  at  the  eentral  part,  and  brings  the  hand  up  to  9,  10. 

The  complication,  variety,  and  swiftness  of  motion,  executed  by 
muscles,  are  past  eonception.  Every  movement  which  a human  be- 
ing makes,  from  the  heavier  motions  of  the  farmer  in  cultivating  his 
fields,  up  to  the  magic  touches  of  the  painter’s  brush,  and  the  method- 
ical frenzy  with  which  the  great  master’s  fingers  sweep  the  piano,  are 
all  made  by  muscles  obeying  an  intelligent  will. 

The  Teeth. 

The  teeth  are  not  like  other  bones,  either  in  composition,  method 
of  nutrition,  or  growth.  When  broken  they  do  not  unite,  not  being 
furnished  with  the  neeessary  power  of  reproduction  of  lost  parts. 

Both  the  upper  and  lower  teeth  are  set  into  bony  sockets,  called 
alveolar  processes.  These,  with  the  fibrous  gums,  give  the  teeth  a 
very  firm  setting. 

Origin. — The  teeth  have  their  origin  in  little  membranous 
pouehes  within  the  bone  of  the  jaw,  which,  in  their  interior,  have  a 
fleshy  bud.  From  the  surface  of  this  the  bone  or  ivory  exudes.  The 
tooth  and  the  bony  socket  are  developed  and  rise  up  together,  — the 
former,  when  sufficiently  long,  pushing  itself  through  the  gum. 

Number. — The  first  set  of  teeth  are  only  temporary,  and  are  called 
milk-teeth.  There  are  but  twenty  of  them.  Between  the  age  of  six 
and  fourteen,  these  become  loose,  and  drop  out,  and  the  permanent 
teeth  appear  in  their  places.  Of  these  there  are  thirty-two,  sixteen 
in  each  jaw. 

Names The  four  front  teeth  in  each  jaw,  a,  h.  Fig.  27,  are  the 

cutting  teeth  (incisors)  ; the  next  one,  c,  is  an  eye-tooth  (euspid) ; the 


Fig.  27. 


next  two,  d,  e,  are  small  grinders  (bicuspids)  ; the  last  three,  /,  A, 
are  grinders  (molars).  One  appears  late  on  each  side,  from  the  age 
of  twenty  to  twenty-four,  and  is  called  wisdom  tooth. 


ANATOMY. 


35 


Composition. — A tooth  is  composed  of  ivory  and  enamel.  The 
internal  part  is  ivory,  which  is  harder  than  bone.  The  coating  upon 
the  surface  is  enamel,  which  is  still  harder  than  ivory.  That  part 
which  rises  above  the  jaw-bone  is  called  the  crown  ; it  is  this  only 
which  is  covered  with  enamel.  The  part  within  the  jaw  is  called  the 
root  or  fang ; this  is  composed  of  bony  matter,  through  which  small 
vessels  pass  in  to  nourish  the  tooth.  Small  white  nerves  also  pass 
into  the  tooth,  — of  the  presence  of  which  we  have  terrible  evidence 
in  tooth-ache. 

Use  of  the  Teeth. 

The  incisors  cut  the  food  asunder;  the  molars  break  down  its 
solid  parts,  and  grind  it  to  a fineness  which  fits  it  for  the  stomach. 

In  masticating  the  food,  the  lower  jaw  has  two  movements,  the  up- 
and-down  motion,  like  a pair  of  shears,  and  the  lateral  or  grinding 
motion.  These  two  movements  are  performed  by  different  sets  of 
muscles.  Flesh-eating  animals  have  only  the  up-and-down  motion ; 
vegetable-eating  animals  have  only  the  lateral  or  grinding  motion  ; 
while  man  has  both  the  up-and-down  and  the  lateral.  This  seems 
a pretty  clear  intimation  that  he  is  to  eat  both  flesh  and  vegetables. 

The  teeth  aid  us  in  articulating  words,  and  they  give  a roundness 
and  symmetry  to  the  lower  part  of  the  face.  When  well  formed,  and 
kept  in  good  condition,  they  add  much  to  the  beauty  of  the  face,  and 
their  decay  is  an  irreparable  loss.  Their  proper  care  and  treatment 
are  spoken  of  in  another  place. 

The  Digestive  Organs. 

The  alimentary  organs  are  the  mouth,  the  teeth,  the  salivary  glands, 
the  pharynx,  the  gullet  (oesophagus),  stomach,  bowels  (intestines), 
chyle  vessels  (lacteals),  thoracic  duct,  liver  and  sweetbread  (pan- 
creas). 

The  preparatory  process  of  digestion,  the  mastication  of  food, 
takes  place  in  the  mouth,  where  the  food  is  mixed  with  saliva,  a se- 
cretion of  the  salivary  glands.  Of  these  glands  there  are  six,  three 
on  each  side.  . 

The  Parotid  QIand  lies  in  front  of  the  external  ear.  It  has  a duct 
opening  into  the  mouth  opposite  the  second  molar  tooth  of  the  upper 
jaw.  This  is  the  gland  that  swells  in  the  disease  called  mumps. 
Hence  the  disease  is  also  called  parotitis. 

The  Submaxillary  Gland  is  inclosed  within  the  lower  jaw,  in  front 
of  its  angle.  Its  duct  opens  into  the  mouth  by  the  side  of  the  bridle 
of  the  tongue  (froenum  linguae). 

On  each  side  of  this  string  or  bridle,  and  under  the  mucous  mem.- 
brane  of  the  floor  of  the  mouth,  lies  the  sublingual  gland,  which 
pours  its  saliva  into  the  mouth,  through  seven  or  eight  small  ducts 


36 


ANATOMY. 


A disease  called  the  frog  consists  in  the  swelling  of  this  gland. 
Fig.  28:  1,  the  parotid  gland;  2,  its  duct;  3,  the  submaxillary; 

4,  its  duct ; 5,  the  sublin- 
gual. 

The  Pharynx  is  a con- 
tinuation of  the  mouth,  and 
is  the  cavity  just  below  the 
soft  palate.  The  two  pas- 
sages going  to  the  nose 
(posterior  nares),  the  one 
going  to  the  stomach 
(oesophagus),  and  the  one 
going  to  the  lungs  (larynx 
and  trachea ; all  meet  in 
this  cavity.  In  Fig.  29: 
1,  is  the  trachea ; 2,  the 


larynx  ; 3,  the  oesophagus  ; 
4,  4,  4,  muscles  of  pharynx ; 5,  muscles  of  the  cheek ; 6,  the  muscle 
which  surrounds  the  mouth  ; 7,  the  mus- 
cle forming  the  floor  of  the  mouth. 

The  QuUet  or  oesophagus  is  a long  tube, 
descending  behind  the  windpipe,  the 
lungs,  and  the  heart,  through  the  dia- 
phragm into  the  stomach.  It  is  composed 
of  two  membranes  laid  together,  like  two 
pieces  of  cloth.  The  inner  one  is  mucous, 
the  outer  muscular.  The  two  sets  of 
fibres  composing  the  muscular  coat  are 
arranged  circularly  and  longitudinally 
(Fig.  25). 

The  Stomach  lies  in  the  upper  part  of 
the  belly,  to  the  left,  and  directly  under 
the  diaphragm.  It  has  an  upper  opening, 
where  the  stomach-pipe  enters  it,  called 
the  cardiac  orifice.  This  is  the  larger  end  of  the  stomach,  and  lies 
on  the  left  side ; the  smaller  end  connects  with  the  upper  bowel,  at 
which  point  it  has  an  opening  called  the  pyloric  orifice.  In  addition 
to  mucous  and  muscular  coats,  similar  to  those  which  compose  the 
oesophagus,  the  stomach  has  still  another  over  both,  a serous  coat, 
very  strong  and  tough,  to  give  this  working  organ  additional  en- 
durance. Within,  it  has  many  glands  to  secrete  the  gastric  juice. 


Fig.  29. 


The  Intestines,  or  alimentary  tube,  or  hoivels.,  are  divided  into  the 
small  and  large  intestines. 

The  small  intestine  has  a length  of  about  twenty-five  feet,  and  is 
divided  into  three  parts,  — the  duodenum,.,  the  jejunum,  and  the  ileum. 
Of  these  three  divisions,  the  duodenum  is  the  largest,  and  is  about 


ANATOMY. 


37 


a foot  in  length.  It  begins  at  the  pyloric  orifice  of  the  stomach,  and 
passes  backward  to  the  under  surface  of  the  liver,  whence  it  drops 
down  perpendicularly  in  front  of  the  right  kidney,  and  passes  across 
the  belly  behind  the  colon,  and  ends  in  the  jejunum. 

The  Jejunum  continues  the  above,  and  terminates  in  the  ileum. 

The  Ileum  is  a continuation  of  the,  jejunum.,  and  opens,  at  an  obtuse 
angle,  near  the  haunch  bone,  into  the  colon.  A valve  is  located  here, 
to  prevent  the  backward  passage  of  substances  from  the  colon  into 
the  ileum. 

At  this  point  the  large  intestines  begin,  and  here  is  situated  the 
caecum.,  a blind  pouch,  or  cul-de-sac,  attached  to  which  is  the  appen- 
dix vermiformis,  a worm-shaped  tube,  of  the  size  of  a goose-quill,  and 
from  one  to  six  inches  long. 

The  Colon,  or  large  intestine,  is  divided  into  the  ascending  colon,  the 
transverse  colon,  and  the  descending  colon. 

The  Ascending  Colon  rises  from  the  right  haunch-bone  to  the  under 
surface  of  the  liver,  whence  it  bends  inward,  and  crosses  the  upper 
part  of  the  belly,  below  the  liver  and  stomach,  to  the  left  side.  This 
portion  which  crosses  over  is  the  transverse  colon.  From  this  point, 
on  the  left  side,  it  turns  down  to  the  left  haunch,  and  has  the  name 
of  the  descending  colon.  Here  it  makes  a curve  like  the  letter  S, 
which  is  called  the  sigmoid  flexure. 

TSie  Rectum  is  the  lower  portion  of  the  large  intestine,  terminat- 
ing at  the  anus. 

The  Lacteals  are  small  vessels  which  begin  in  the  villi,  upon  the 
mucous  membrane  of  the  small  bowels.  From  here  they  pass  be- 
tween membranes  of  the  mesentery  to  small 
glands,  from  which  larger  vessels  run  to 
another  collection  of  glands;  and  after 
passing,  for  a space,  from  one  collection  of 
glands  to  another,  at  each  stage  of  their 
progress  increased  in  size  and  diminished 
in  number,  the  lacteals  pour  their  contents 
into  the  thoracic  duct.  This  having  passed 
up  through  the  diaphragm,  out  of  the 
belly,  makes  a sudden  turn  downward  and 
forward,  and  empties  its  burden  into  a 
large  vein  which  ends  in  the  right  heart. 

Fig.  30 : 1,  is  the  bowel ; 2,  3,  4,  the 
mesenteric  glands  through  which  the  lac- 
teals pass ; 5,  the  thoracic  duct ; 7,  the  spinal  column ; 8,  the 
diaphragm. 

By  the  help  of  a magnifying  glass,  an  infinite  number  of  these 
small  vessels  may  be  seen  starting  from  the  rough,  shaggy  internal 
coat  of  the  bowel. 


38 


ANATOMY. 


The  mesentery  is  a thick  sheet  of  membrane,  formed  of  several 
folds  of  the  peritoneum,  and  spread  out  from  the  vertebrae  like  a fan. 
The  bowels  are  attached  to  its  edge,  and  are  held  by  it  in  their  place, 
and  at  the  same  time  have  free  motion.  Between  its  layers  are  a 
great  number  of  glands,  which  sometimes  become  diseased  and  swol- 
len in  childhood,  and  prevent  the  chyle  from  passing  along  to  the 
thoracic  duct.  Thus  affected,  children  are  not  nourished,  and  waste 
away  with  a disease  sometimes  called  mesenteric  consumption. 

The  Liver  is  a large  gland,  lying  under  the  short  ribs  on  thejight 
side,  below  the  diaphragm.  It  is  convex  on  the  upper  surface  and 

concave  on  the  under,  and  is 
composed  of  several  lobes.  Its 
office  is  to  secrete  bile.  It 
weighs  about  four  pounds, 
being  the  largest  organ  in  the 
body.  Fig.  31  represents  the 
liver:  1,  being  the  right  lobe; 
2,  left  lobe ; 3, 4,  smaller  lobes ; 
10,  gall-bladder ; 17,  the  notch 
into  which  the  spinal  column 
is  fitted. 

The  GalLBladder  lies  on 
the  under  side  of  the  liver,  and  receives,  it  is  supposed,  the  surplus 
bile,  which  is  reserved  for  special  occasions.  It  opens  into  the  gall- 
duct,  which  carries  the  bile  along,  and  pours  it  into  the  duodenum. 

The  Pancreas,  Fig.  32,  is  a long,  flat  gland,  something  like  the 
salivary  glands.  It  lies  transversely  across  the  back  wall  of  the  ab- 
domen, behind  the  stomach. 

It  secretes  a colorless,  al- 
kaline fluid  called  the  2^mir 
creatic  juice^  the  office  of 
which  is  to  emulsify  the 
different  classes  of  food, 
so  that  the  lacteals  can  ab- 
sorb it.  This  fluid  is  car- 

ried  by  a duct,  and  poured  into  the  duodenum  just  where  the  bile- 
duct  enters. 

The  Spleen  has  an  oblong,  flattened  form.  It  lies  on  the  left 
side,  just  under  the  diaphragm,  and  close  to  the  stomach  and 
pancreas.  It  is  supposed  to  be  a reservoir  for  holding  the  surplus 
blood  of  the  liver.  It  was  thought  by  the  ancients  to  be  the  seat  of 
melancholy.  The  blood  in  passing  through  it  loses  a portion  of  its 
red  globules. 

The  Omentum  or  caul  is  a doubling  and  extension  of  the  perito- 
neum. It  is  a kind  of  fatty  body,  which  lies  upon  the  surface  of  the 


AITATOMY. 


39 


bowels  and  is  attached  to  the  stomach.  Its  use  seems  to  be  to  lubri- 
cate the  bowels,  and  especially  to  protect  and  keep  them  warm. 
Hence  it  is  often  called  the  apron. 


The  Urinary  System. 

The  organs  of  this  system  are  devoted  to  separating  the  urine  from 
the  blood,  and  carrying  it  out  of  the  body.  These  organs  are  the 
Mdneys,  the  ureters.,  the  bladder.,  and  the  urethra. 

The  Kidneys  lie  one  on  each  side  of  the  backbone,  in  the  lumbar 
region,  behind  the  peritoneum.  They  are  four  or  five  inches  long, 
and  two  and  a half  broad.  They  are  in  shape  like  the  kidney-bean, 
and  weigh  about  half  a pound  each.  In  the  centre  there  is  a bag 
called  the  pelvis,  which  tapers  like  a funnel,  and  unites  with  the 
ureter  which  conveys  the  urine  to  the  bladder.  The  texture  of  the 
kidney  is  dense,  presenting  in  its  interior  two  structures,  an  external 
or  cortical,  and  an  internal  or  medullary.  The  cortical  portion  has 
the  blood-vessels,  the  medullary  is  composed  of  tubes  which  carrj 
away  the  urine. 

The  Ureters  are  membranous  tubes  of  the  size  of  a goose-quill, 
and  eighteen  inches  long,  which  run  down  the  back  wall  of  the  abdo- 
men, behind  the  peritoneum,  to  the  bladder,  into  each  side  of  which 
they  empty  their  contents. 

The  Bladder  is  located  in  the  pelvis,  in  front  of  the  rectum.  It  is 
composed  of  three  coats ; the  external  is  serous,  the  middle  muscular, 
and  the  internal  mucous.  The  external  coat  is  strong  and  fibrous  ; 
the  internal  is  drawn  into  wrinkles,  which  makes  it  thick  and  shaggy; 
it  secretes  a mucus  which  prevents  it  from  being  injured  by  the  cor- 
rosiveness of  the  urine.  The  urine  is  retained  in  the  bladder  by 
means  of  a circular  muscle,  called  a sphincter,  which  draws  the  mouth 
of  the  organ  together.  When  the  quantity  of  urine  is  so  increased 
as  to  give  some  uneasiness  or  pain,  this  muscle,  by  a sort  of  instinct, 
relaxes  and  lets  it  out. 

The  bladder  is  attached  to  the  rectum,  to  the  hip-bones,  to  the 
peritoneum,  and  to  the  navel,  by  several  ligaments.  In  the  female 
the  bladder  has  the  womb  between  it  and  the  rectum. 

This  organ  is  wisely  provided  as  a receptacle  for  the  urine ; which, 
without  it,  would  produce  a great  inconvenience  by  being  constantly 
dribbling  away. 

The  Urethra  is  a membranous  canal  which  leads  from  the  neck 
of  the  bladder.  It  is  composed  of  two  layers,  a mucous  and  an  elas- 
tic fibrous.  Through  this  channel,  which  is  curved  in  its  course,  the 
urine  passes  out  of  the  body. 


40 


ANATOMY. 


The  Respiratory  Organs. 

These  organs  consist  of  the  windpipe  (trachea)  ; divisions  and 
subdivisions  of  the  windpipe  (bronchia)  ; air-cells ; and  the  lungs  or 
lights. 

The  Windpipe  (trachea)  extends  from  the  larynx — the  seat  of  the 
voice — to  the  third  dorsal  vertebra,  where  it  divides  into  two  tubes, 
called  bronchia.  It  runs  down  the  front  part  of  the  throat,  with  the 
oesophagus  behind  and  between  it  and  the  spinal  column.  It  is  com- 
posed mainly  of  rings  of  cartilage,  one  above  another. 

The  Bronchial  Tubes  are,  at  the  division  of  the  windpipe,  two  in 
number,  but  they  divide  and  subdivide  until  they  become  very  nu- 
merous. 

The  Air-Cells  or  Vesicles  are  small,  bladder-like  expansions  at  the 
ends  of  the  tubes.  They  are  elastic  and  swell  out  when  the  air 
passes  in. 

The  Lungs  fill  the  greater  part  of  the  chest,  the  heart  being  the 
only  other  organ  which  occupies  much  space  in  the  cavity.  The 
size  of  these  organs  is  large  or  small,  according  to  the  capacity  of  the 
chest.  Each  lung  — for  there  are  two  — is  a kind  of  cone,  with  its 
base  resting  upon  the  diaphragm,  and  its  apex  behind  the  collar-bone. 
They  are  concave  on  the  bottom,  to  fit  the  diaphragm,  which  is  con- 
vex on  its  upper  side. 

The  right  and  left  lungs  are  separated  from  each  other  by  a parti- 
tion called  the  mediastinum.,  formed  by  two  portions  of  the  pleura,  a 
smooth  serous  membrane  coming  off  from  the  spine  and  closely  en- 
veloping each  lung ; the  heart,  covered  by  the  pericardium,  lies 
in  the  centre,  between  them.  The  right  lung  is  divided  into  three 
lobes ; the  left  into  two. 

Each  lobe  of  the  lungs  is  divided  into  a great  many  lobules,  which 
are  connected  by  cellular  tissue.  These  lobules  are  again  divided 
into  very  fine  air-cells.  Besides  these,  the  substance  of  the  lungs  is 
composed  likewise  of  blood-vessels  and  lymphatics,  and  is  well  sup- 
plied with  nerves. 

In  the  foetal  state,  before  the  lungs  have  been  filled  with  air,  they 
are  solid  and  heavy,  sometliing  like  other  flesh,  but  after  all  their 
cells  have  been  filled  with  air,  and  breathing  has  been  established, 
they  are  exceedingly  light  and  spongy,  and  float  upon  water. 

In  cases  where  infanticide  is  suspected,  and  where  it  is  desirable 
to  know  whether  the  child  was  still-born,  or  born  alive  and  killed 
afterwards,  the  specific  gravity  of  the  lungs,  compared  with  water, 
will  often  settle  the  question. 


ANATOMY. 


41 


The  Organs  of  Circulation. 

The  food  having  been  digested,  changed  to  chyle,  absorbed  by  the 
lacteals,  carried  to  the  veins,  poured  into  the  right  heart,  sent  up  to 
the  lungs,  and  prepared  for  nourishing  the  body,  will  still  be  useless, 
if  not  distributed  to  every  part  of  the  system.  The  organs  for  ef- 
fecting this  distribution  are  the  heart,  the  arteries,  the  veins,  and  the 
capillaries. 

The  Heart  is  placed  obliquely  in  the  chest,  with  one  lung  on  each 
side,  and  is  enclosed  between  the  two  folds  of  the  mediastinum  Its 
form  is  something  like  a cone.  Its  base  is  turned  upward  and  back- 
ward in  the  direction  of  the  right  shoulder;  the  apex  forward  and  to 
the  left,  occupying  the  space  between  the  fifth  and  sixth  ribs,  about 
three  inches  from  the  breast-bone.  It  is  surrounded  by  a membranous 
case  or  sac,  called  the  pericardium. 

The  heart  is  a muscular  body,  and  has  its  fibres  so  interwoven  that 
it  is  endowed  with  great  strength.  It  is  a double  organ,  having  two 
sides,  a right  and  a left,  which  are  divided  from  each  other  by  a mus- 
cular partition,  called  a septum.  The  right  heart  sends  the  blood  to 
the  lungs  ; the  left  heart  distributes  it  to  the  general  system.  Each 
side  is  ^vided  into  two  compartments,  an  auricle  and  a ventricle. 

The  Auricles  have  thinner  walls  than  the  ventricles,  being  only 
reservoirs  to  hold  the  blood  until  the  ventricles  force  it  along  to  other 
parts. 

The  Ventricles  have  within  them  fleshy  columns,  called  columnce 
carnecB.  The  walls  of  the  left  ventricle  are  thicker  than  those  of  the 
right,  being  required  to  contract  with  more  force.  Each  of  the  four 
cavities  will  contain  from  one  and  a half  to  two  ounces  of  blood. 

The  Tricuspid  valves  are  situated  between  the  auricle  and  ventricle 
on  the  right  side,  and  consist  of  three  folds  of  a thin,  triangular 
membrane.  The  mitral  valves  occupy  the  same  position  on  the  left 
side.  Small  white  cords,  called  chordae  tendinoe, 
pass  from  the  floating  edge  of  these  to  the 
columnae  carneae,  to  prevent  the  backward  press- 
ure of  the  blood  from  carr}dng  the  valves  into 
the  auricles. 

The  pulmonary  artery  is  the  outlet  of  the 
right  ventricle ; the  larger  artery,  called  aorta, 
of  the  left  ventricle.  At  the  opening  of  these 
arteries  are  membranous  folds,  called  semilunar 
valves.  Fig.  33  gives  a fine  view  of  the  heart : 

1,  is  the  right  auricle  ; 2,  the  left  auriele;  3,  the 
right  ventricle;  4,  the  left  ventricle;  5,  6,  7,  8, 

9,  10,  the  vessels  which  bring  the  blood  to  and  carry  it  away 
the  heart. 


42 


ANATOMY. 


The  Arteries  are  the  round  tubes  which  carry  the  red  blood  from 
the  left  side  of  the  heart  to  every  part  of  the  body. 

The  sides  of  arteries  are  stiff  and  hard,  and  do  not  fall  together 
when  empty.  They  may  often  be  seen  open  in  a piece  of  boiled  beef. 

The  arteries  have  three  coats, — an  external,  which  is  cellular,  firm 
and  strong ; a middle,  which  is  fibrous  and  elastic ; and  an  internal, 
which  is  serous  and  smooth,  being  a continuation  of  the  lining  of 
the  heart.  They  are  siirrounded  by  a cell  vestment  called  a sheath^ 
which  separates  them  from  surrounding  organs. 

The  Pulmonary  Artery  starts  from  the  right  ventricle  in  front  of 
the  opening  of  the  aorta,  and  ascends  to  the  under  surface  of  the 
aortic  arch,  where  it  parts  into  two  branches,  sending  one  to  the  right, 
the  other  to  the  left  lung.  Having  divided  and  subdivided  to  a great 
extent,  they  end  in  the  capillary  vessels,  uniting,  joining  their  mouths, 
and  becoming  continuous  with  the’  pulmonary  veins  just  where  they 
pass  around  the  air-cells. 

The  Aorta  is  the  largest  artery  in  the  body.  It  takes  a slight  turn 
in  the  chest,  called  the  arch  of  the  aorta^  from  which  are  given  off  the 
arteries  which  carry  the  blood  to  the  head,  etc. ; thence  it  descends 
into  the  belly  along  the  side  of  the  backbone,  and  at  the  bottom  of 
the  abdomen  it  divides  into  two  arteries,  called  the  iliacs  — one  going 
to  each  of  the  lower  limbs.  The  branches  the  aorta  gives  off  a supply 
of  red  blood  to  every  part  of  the  body. 

The  Veins  carry  the  dark  or  purple  blood.  Being  made  red  and 
vital  by  meeting  atmospheric  air  in  the  lungs,  and  then  conveyed  to 
every  part  of  the  body  in  the  arteries,  the  blood  loses  its  redness  in 
the  capillaries,  and  comes  back  to  the  heart  in  the  veins,  dark  and 
purple,  and  unfit  to  support  life.  The  veins  are  more  numerous  and 
nearer  the  surface  than  the  arteries.  They  have,  likewise,  thinner 
walls,  and  when  empty,  they  collapse  or  fall  together.  They  begin 
in  the  small  capillaries,  and  running  together,  they  grow  larger  and 
larger,  and  finally  form  the  great  trunks  which  pour  the  dark  blood 
into  the  right  auricle.  The  veins  are  composed  of  three  coats,  simi- 
lar to  those  of  the  arteries,  with  the  exception  of  being  thinner  and 
more  delicate.  These  vessels  have  valves  all  along  their  inner  sur- 
face, to  aid  in  circulating  the  blood. 

The  large  vein  which  receives  all  the  dark  blood  from  above,  and 
pours  it  into  the  right  auricle,  is  called  the  vena  cava  descendens  ; the 
one  which  takes  it  from  below,  and  disposes  of  it  in  the  same  manner, 
is  the  vena  cava  ascendens. 

The  pulmonary  veins  bring  the  red  blood  from  the  lungs  to  the  left 
auricle,  and  thus  are  exceptional  in  their  use,  — being  the  only  veins 
which  carry  red  blood. 

The  Capillaries  are  the  extremely  fine  network  of  vessels  between 
the  ends  of  the  arteries  on  the  one  side,  and  of  the  veins  on  the  other. 


ANATOMY, 


43 


They  inosculate,  or  join  their  mouths  to  the  very  small  arteries  at 
one  end,  and  to  the  equally  small  veins  at  the  other.  They  are  the 
industrious  little  builders  of  the  human  frame.  Receiving  the  blood, 
red,  and  full  of  life,  from  the  terminal  extremities  of  the  arteries, 
they  take  the  living  particles  out  of  it,  and  apply  them  to  the  renewing 
and  vitalizing  of  the  body,  and  then  pass  it  along  into  the  hair-like 
beginnings  of  the  veins,  dark  and  bereft  of  vitality,  to  be  carried  up 
for  another  freight  of  chyle,  and  to  be  again  vitalized  by  being  touched 
in  the  lungs  by  the  breath  of  heaven. 

In  Fig.  34  we  have  a good  ideal  illustration  of  the  whole  circu- 
lation. From  the  right  ventricle  of  the  heart,  2,  the  dark  blood  is 
thrown  into  the  pulmonary  ar- 
tery, 3,  and  its  branches,  4,  4, 
carry  it  to  both  lungs.  In  the 
capillary  vessels,  6,  6,  the  blood 
comes  in  contact  with  the  air, 
and  becomes  red  and  vitalized. 

Thence  it  is  returned  to  the  left 
auricle  of  the  heart,  9,  by  the 
veins,  7,  8.  Thence  it  passes 
into  the  left  ventricle,  10.  A 
forcible  contraction  of  this 
sends  it  forward  into  the  aorta, 

11.  Its  branches,  12,  13,  13, 
distribute  it  to  all  parts  of  the 
body.  The  arteries  terminate 
in  the  capillaries,  14,  14.  Here 
the  blood  loses  its  redness,  and 
goes  back  to  the  right  auricle, 

1,  by  the  vena  cava  descendens, 

15,  and  the  vena  cava  ascend- 
ens,  16.  The  tricuspid  valves, 

17,  prevent  the  reflow  of  the 
blood  from  the  right  ventricle 
to  the  right  auricle.  The  semi- 
lunar valves,  18,  prevent  the 
blood  from  passing  back  from  the  pulmonary  artery  to  the  right 
ventricle.  The  mitral  valves,  19,  prevent  its  being  forced  back  from 
the  left  ventricle  to  the  left  auricle.  The  semilunar  valves,  20,  pre- 
vent the  backward  flow  from  the  aorta  to  the  left  ventricle. 

By  a careful  examination  of  this  diagram,  with  these  explanations, 
the  reader  may  understand  the  circulation  very  well. 

The  passage  of  the  blood  from  the  right  heart,  through  the  lungs, 
and  back  to  the  left  heart,  is  called  the  lesser,  or  pulmonic  circulation  ; 
its  passage  from  the  left  heart  through  all  parts  of  the  body,  and  back 
to  the  right  heart,  is  the  greater  or  systematic  circulation. 


44 


ANATOMY. 


The  Absorbent  Vessels. 


The  vessels  which  absorb  the  chyle  from  the  small  intestines,  and 
convey  it  onward  towards  the  blood,  are  the  lacteals.  They  have 
been  described.  The  veins  are  also  supposed  to  have  the  power  of 

absorption,  particularly  the  small 
commencements  of  the  veins. 
These  have  likewise  been  de- 
scribed. 


The  Lymphatic  vessels  resemble  the  lacteals.  They  abound  in  the 
skin,  the  mucous  membranes, 
and  the  lungs.  They  are 
very  small  at  their  origin, 
and,  like  the  veins,  they  in- 
crease in  size,  as  they  dimin- 
ish in  numbers.  Like  the 
veins,  too,  they  travel  to- 
wards the  heart,  and  their 


Fig.  36,  Fig.  37. 

contents  are  poured -into  it. 
Their  walls  are  composed  of 
two  coats ; the  external  is 
cellular,  and  distensible  ; the 
internal  is  folded  into  valves, 
like  that  of  the  veins. 

These  vessels,  on  their 
way  to  the  heart,  pass 
through  soft  bodies,  called 
lymphatic  glands^  which  bear 
to  them  the  relation  that  the 
mesenteric  glands  do  to  the 


Fig.  38. 


ANATOMY. 


45 


lacteals.  These  glands  are  a collection  of  small  vessels.  The 
lymphatic  glands  are  most  numerous  in  the  neck,  chest,  abdomen, 
arm-pits,  and  groins.  They  are  also  found,  to  some  extent,  in  other 
parts  of  the  body.  Fig.  35  shows  a single  lymphatic  vessel,  much 
magnified ; Fig.  36  exhibits  the  valves  along  one  of  the  lymphatic 
trunks ; Fig.  37  shows *''a  lymphatic  gland  with  the  vessels  passing 
through  it. 

Fig.  38jepresents  the  lymphatic  vessels  and  glands.  1,  2,  3,  4,  6, 
6,  show  these  vessels  of  the  lower  limbs ; 7,  the  inguinal  glands ; 8, 
the  commencement  of  the  thoracic  duct,  into  which  the  contents  of 
lymphatic  are  poured;  9,  the  lymphatics  of  the  kidneys;  10,  those 
of  the  stomach;  11,  those  of  the  liver;  12,  12,  those  of  the  lungs  ; 
13,  14,  15,  those  of  the  arm;  16,  17,  18,  those  of  the  face  and  neck ; 
19,  20,  the  large  veins  ; 21,  the  thoracic  duct;  26,  the  lymphatics  of 
the  heart. 

A cold  will  often  cause  lymphatic  glands  to  swell.  These  swell- 
ings are  ca,lled  Tcernels.  They  often  swell,  also,  without  the  irritation 
from  cold,  and  become  very  much  and  permanently  enlarged,  particu- 
larly in  scrofula.  In  scrofulous  subjects  they  sometimes  suppurate 
and  break,  forming  bad  sores  upon  the  neck. 


The  Organs  of  Secretion. 

The  exhalants,  follicles,  and  the  glands  are  the  organs  of  secre- 
tion. 

The  Exhalants  are  the  sweat-glands.  These  have  external  termi- 
nations upon  the  skin,  thus  communicating  with  the  air,  and  internal 
terminations  upon  the  surfaces  of  organs  not  having  an  outward  ex- 
posure. 

The  Follicles  are  small  sacs,  located  in  the  true  skin  and  mucous 
membranes.  The  pores  of  the  skin  are  the  mouths  or  outlets  of  these 
little  bags.  Veins  and  organic  nerves  are  sent  to  these  vessels. 

Glands  are  soft  organs,  having  a variety  of  structure,  and  perform 
ing  many  kinds  of  secretion.  A gland  is  made  up  of  several  lobules, 
united  in  one  mass,  and  each  of  these  lobules 
has  a small  duct,  communicating  with  a 
main  duct  which  forms  the  outlet.  Fig.  39 
shows  a gland  ; 2,  the  small  ducts  spread 
through  its  body,  and  running  together; 

1 , the  large  duet,  through  which  the  secreted 
substance  is  carried  away. 

The  mesenteric  and  lymphatic  glands 
merely  modify  the  fluids  which  pass  through 
them ; others  secrete  from  the  blood  either 
fluids  to  be  used  in  the  body,  or  such  as  are  to  be  cast  away. 


46 


ANATOMY. 


The  Vocal  Organs. 

No  sounds  touch  the  heart  like  those  of  the  human  voice,  for  no 
mechanic,  however  scientific  and  skilful,  has  ever  been  able  to  make 
an  instrument  which  could  produce  sounds  as  beautiful,  tones  as 
varied,  a timbre  as  melodious,  and  inflexions  as  manifold  and  agree- 
able. It  has  been  compared  to  wind,  reed  and  stringed  instruments. 
In  touching  expression,  it  is  most  resembled  by  the  concert-horn,  the 
bassoon,  and  the  hautboy. 

Vocal  sounds,  past  all  question,  are  produced  in  the  larnyx,  but 
these  sounds  are  grouped,  or  formed  into  articulate  speech,  by  the 
pharynx,  the  nasal  cavities,  the  tongue,  the  teeth,  etc. 

The  Larynx  is  a kind  of  cavity  or  tube  at  the  top  of  the  windpipe, 
formed  by  the  union  of  five  cartilages,  namely,  the  thyroid,  the  cricoid, 
the  two  arytenoid,  and  the  epiglottis.  Ligaments  bind  these  together, 
and  muscles  move  them. 

The  Thyroid  Cartilage  is  composed  of  two  parts,  and  has  a con- 
nection with  the  bone  of  the  tongue  above,  and  with  the  cricoid  car- 
tilage below. 

The  Cricoid  Cartilage  is  shaped  like  a ring,  and  hence  its  Greek 
name.  It  is  narrowest  in  front,  and  broadest  behind.  It  connects 
with  the  thyroid  cartilage 
above,  and  with  the  first  ring 
of  the  trachea  below.  Fig.  40 
gives  a side  view  of  the  car- 
tilages of  the  larynx : 1,  bone 
at  the  base  of  the  tongue  (os 
hyoides)  : 2,  the  ligament  con- 
necting hyoid  bone  and  the 
thyroid  cartilage  ; 3,  the  front 
of  the  thyroid  cartilage  ; 4,  the 
thyi'oid  cartilage  ; 6,  the  cri- 
coid cartilage ; 7,  the  wind- 
pipe. 

Fig.  40.  ^ back  view  of 

the  cartilages  and  ligaments  of  the  larynx  : 1,  is  the  back  surface 
of  the  epiglottis ; 3,  3,  the  os  hyoides  ; 4,  4,  the  lateral  ligaments 
connecting  the  os  hyoides  and  the  thyroid  cartilage ; 5,  6,  the  back 
face  of  the  thyroid  cartilage ; 6,  6,  the  arytenoid  cartilages ; 7,  the 
cricoid  cartilage ; 8,  the  first  ring  of  the  windpipe. 

The  Arytenoid  Cartilages  are  upon  the  back  part  of  the  cricoid, 
and  are  connected  with  the  thyi’oid  cartilage  by  the  vocal  cords. 

The  Epiglottis  is  a fibro-cartilaginous  lid,  shaped  like  a leaf,  wliich 
covers  the  upper  opening  of  the  larynx.  It  is  connected  by  a carti- 


ANATOMY. 


47 


lage  to  the  bone  of  the  tongue  (os  hyoides)  and  to  the  thyroid  carti- 
lage. Breathing  opens  and  shuts  it ; and  in  swallowing,  it  closes 
down  upon  the  top  of  the  larynx,  to  prevent  food  and  drink  from 
passing  down  the  windpipe. 

The  Vocal  Cords  are  two  ligaments,  formed  of  elastic  and  parallel 
fibres,  enclosed  in  a fold  of  mucous  membrane.  They  are  about  two 
lines  in  width,  and  inserted  behind  into  the  t> 

anterior  projection  of  the  arytenoid  car- 
tilages, and  passing  forward,  are  fixed  to 
the  anterior  angle  of  the  thyroid.  There 
are  four  ligaments  crossing  the  larynx, 
two  superior  and  two  inferior,  — the  lat- 
ter being  called  vocal  cords.  The  interval 
between  them  is  the  glottis.  The  liga- 
ments themselves  are  sometimes  called 
the  lips  of  the  glottis.  The  depression  be- 
tween the  superior  and  inferior  ligaments 
is  the  ventricle  of  the  larynx. 

Fig.  42  represents  a view  of  the  larynx 
from  above : a,  b,  e,  the  thyroid  cartilage,  enclosing  the  ring  of  the 
cricoid ; h,  h,  e,  e,  the  arytenoid  cartilages  connected  by  the  trans- 
verse arytenoid  muscle  ; i,  i,  the  vocal  cords  ; o,  o,  the  crico-arytenoid 
ligaments. 

The  muscles  which  are  attached  to  the  cartilages  have  the  power 
of  pillling  them  about  so  as  to  change  in  various  ways  the  shape  of 
the  larjmgeal  cavity ; to  enlarge  or  diminish  the  size  of  the  glottis  : 
and  to  relax  or  tighten  the  vocal  cords.  By  these  means,  and  some 
others,  the  sounds  of  the  voice  receive  their  various  modifications. 
Tightening  the  cords,  for  example,  raises  the  pitch. 


The  Skin. 

The  skin  is  a membrane  composed  of  two  layers,  covering  the 
entire  person.  The  outer  layer  is  the  scarf-skin  or  cuticle  ; the  inner 
is  the  true  skin  or  cutis  or  corium.  These  layers  differ  in  their  struc- 
ture and  uses. 

The  Scarf-Skin,  called  also  cuticle  and  epidermis,  is  a thin  mem- 
brane, partially  transparent,  like  a thin  shaving  of  horn.  Having  no 
blood-vessels  or  nerves,  and  consequently  no  feeling,  it  appears  to  be 
a simple  covering  to  protect  the  true  skin  from  injury  by  external 
agents.  It  is  thickest  on  those  parts  most  exposed  to  friction. 

The  scarf-skin  is  the  production  of  the  true  skin,  — an  exudation 
from  it  in  the  shape  of  a fluid  which  is  spread  out  as  a thin  layer, 
and  dries  up  into  flattened  scales.  The  cuticle  is  composed  chiefly 
of  these  scales,  and  is  constantly  being  rubbed  off  as  scurf,  while 
new  layers  are  forming  underneath. 


48 


ANATOMY. 


The  lower,  softer  layer  of  the  scarf-skin,  called  the  malpighian 
layer,  or  rete  mucosum,  is  the  seat  of  color.  In  this  part  the  cells 
contain  a pigment  incorporated  with  the  elementary  granules,  which 
gives  to  the  various  races  their  several  shades  of  color.  The  depth 
of  hue  is  dependent  entirely  on  the  amount  of  this  coloring  matter. 


The  True  Skin,  which  is  called  cutis,  derma  or  coriiim,  is  a Idnd  of 
web,  woven  of  small  fibres  collected  into  strands.  In  the  upper  por- 
tion, the  web  is  fine  and  firm,  but  grows  coarser  below.  Connected 


Fig.  43. 


e e « 

Fig.  44. 


with  its  under  surface  is  a fibrous  web  in  which  the  fat  is  deposited. 
Upon  its  upper  surface  is  the  sensitive  or  papillary  layer,  composed 
of  blood-vessels  and  nerves,  doubled  into  loops,  which  give  little 
prominences  called  papillae.  Fig.  43  gives  an  ideal  view  of  these 
elevations,  composed  as  they  are,  of  a nerve,  an 
artery,  and  a vein,  lying  side  by  side ; 1,  1, 
represent  the  true  skin ; 2,  2,  the  papillary 
layer;  3,  3,  the  arteries;  4,  4,  the  veins;  and 
5,  5,  the  nerves  of  the  papillae. 

The  arteries,  veins,  and  nerves  are  spread 
over  the  true  skin  in  great  numbers,  — so  pro- 
fusely, that  it  is  impossible  to  push  the  point  of 
the  finest  needle  into  it,  without  piercing  a 
blood-vessel  and  a nerve. 

Fig.  44  gives  a view  of  the  skin : a,  a,  the 
cuticle ; b,  b,  the  colored  layer  of  the  cuticle ; 
c,  (?,  d,  d,  the  true  skin ; e,  e,  e,  faUcells ; /,  /,  /, 
sweat-tubes. 

The  lymphatics  are  very  numerous  in  the  skin,  besides  which  there 
are  oil-glands  and  tubes,  and  sweat-glands  and  tubes. 


Fig.  45. 


The  Oil-Glands  are  imbedded  in  the  skin,  and  communicate  with 
the  surface  by  small  tubes.  They  are  most  abundant  on  the  face, 


ANATOMY. 


49 


nose  and  ears.  Fig.  45  shows  an  oil-gland,  — a,  being  the  gland,  5. 
the  tube,  and  <?,  its  mouth. 


^ 1 2 


3 2 Fig.  46. 

The  Sweat=Apparatus  consists  of  small  tubes  which  pass  down 
through  the  true  skin,  and  terminate  in  the  meshes  at  the  bottom, 
where  it  coils  upon  itself  into  a kind  of  bundle,  called  the  perspira- 
tory gland.  Fig.  46  gives  one  of  these  tubes,  with  the  gland,  mag- 
nified forty  diameters ; 1,  being  the  coiled  tube  or  gland ; 2,  2,  the 
two  excretory  ducts  from  the  gland.  These  uniting  form  one  spiral 
tube,  which  opens  at  4,  which  is  the  surface  of  the  cuticle ; 3,  are  the 
fahcells. 

The  hair  and  the  nails  are  appendages  of  the  skin. 


The  Nervous  System. 


The  Nervous  System  consists  of  the  brain  and  spinal  cord.,  con- 
nected with  each  other,  and  called  the  cerebrospinal  axis  ; the  cranial 
nerves ; the  spinal  nerves  and  the  sympathetic  nerve. 

The  Brain  is  that  mass  of  nervous  matter  lodged  within  the  skull- 
bones.  It  is  made  up  of  three  prin- 
cipal parts,  — the  cerebrum.,  the  cere- 
bellum., and  the  medulla  oblongata. 

These  are  nicely  covered  and  pro- 
tected by  three  membranes,  the  dura 
mater.,  the  arachnoid,  and  the  pia 
mater. 

Fig.  47  shows  a considerable  por- 
tion of  the  brain,  — the  skull-bones 
and  membranes  being  removed. 

The  scalp  turned  down  is  repre- 
sented by  A,  A ; E,  E,  E,  show  the  cut 
edge  of  the  bones ; c,  is  the  dura 
mater,  drawn  up  with  a hook ; F, 
the  convolutions  of  the  brain. 


The  Cerebrum  is  the  upper  and 
larger  portion  of  the  brain,  and  is 


Fig.  47. 


50 


ANATOMY. 


divided  into  two  hemispheres  by  a fissure.  A portion  of  the  dura 
mater  dips  into  this  cleft,  and  from  its  resemblance  to  a sickle,  is 
called  the  falx  cerebri.  The  design  of  this  seems  to  be  to  support 
each  half  of  the  brain,  and  to  prevent  it  from  pressing  upon  the  other 
half  when  the  head  reclines  to  one  side. 

The  undulating  surface  of  the  cerebrum  is  produced  by  what  are 
called  convolutions.  The  lower  surface  of  this  organ  is  divided  into 
three  lobes,  — the  anterior,  the  middle,  and  the  posterior. 

The  surface  of  the  cerebrum  is  of  a gray  color,  called  cortical.,  or 
cineritious ; the  central  portion  is  white  and  fibrous,  and  is  called 
medullary. 

The  Cerebellum  is  about  one-sixth  the  size  of  the  cerebrum.  It 
lies  just  under  the  posterior  lobe  of  the  cerebrum,  and  is  separated 
from  it  by  an  extension  of  the  dura  mater,  called  the  tentorium.  It 
is  composed  of  white  and  gray  matter ; when  the  former  is  cut  into, 
there  is  presented  the  appearance  of  the  trunk  and  branches  of  a tree., 
called  arbor  vitce. 

The  Medulla  Oblongata  is  the  top  of  the  spinal  cord;  but  being 
within  the  enclosure  of  the  skull,  it  passes  for  a portion  of  the  brain. 
It  consists  of  three  pairs  of  bodies,  united  so  as  to  form  a bulb. 

The  Dura  Mater  is  a strong,  fibrous  membrane  which  lines  the 
skull  and  spinal  column,  and  sends  processes  inward  to  support  the 
brain,  and  forward,  as  sheaths  for  the  nerves  which  go  out  from  the 
brain  and  spinal  cord. 

The  Arachnoid  is  a serous  membrane,  and  like  all  other  serous 
membranes,  is  a closed  sac.  It  is  reflected  upon  the  ihner  surface  of 
the  dura  mater. 

The  Pia  Mater  is  a vascular  membrane,  and  lies  next  to  and  in- 
vests the  whole  surface  of  the 
brain,  — dipping  into  its  con- 
volutions. It  furnishes  nu- 
triment to  the  brain. 

The  Cranial  Nerves  which 
go  out  from  the  brain  are  in 
twelve  pairs.  In  reading  a 
description  of  them,  let  the 
reader  keep  his  eye  on  Fig.  48. 

The  First  Pair,  olfactory 
(6),  passes  through  several 
small  openings  in  the  ethmoid 
bone,  and  is  distributed  to 
the  mucous  membrane  which 
lines  the  nose.  Destroy  this, 
and  the  sense  of  smell  is  gone. 


Fig  48. 


ANATOMY. 


51 


The  Second  Pair,  optic  nerve  (7),  passes  through  the  base  of  the 
skull,  and  enters  the  cavity  of  the  eye  where  it  is  expanded  upon  the 
retina.  It  is  a disease  of  this  nerve  which  occasions  a gradual  loss 
of  sight,  called  amaurosis. 

The  Third  Pair,  motores  oculorum  (9),  passes  through  the  sphe- 
noid bone  to  the  muscles  of  the  eye. 

The  Fourth  Pair,  patheticus  (10),  passes  to  the  superior  oblique 
muscle  of  the  eye. 

The  Fifth  Pair,  trifacial  nerve  (11),  like  the  spinal  nerves,  has  two 
roots,  and  divides  into  three  branches,  one  going  to  the  eye,  forehead, 
and  nose,  called  the  ophthalmic  branch ; another  going  to  the  eye, 
the  teeth  of  the  upper  jaw,  etc.,  called  the  superior  maxillary  ; and 
the  third  going  to  the  ear,  the  tongue,  and  the  teeth  of  the  lower 
jaw,  and  called  the  inferior  maxillary.  It  is  a painful  condition  of 
the  branches  of  the  fifth  pair  which  constitutes  the  terrible  neuralgic 
affection  called  tic-douloureux. 

The  Sixth  Pair,  abducentes  (12),  passes  the  opening  by  which  the 
carotid  artery  enters  the  cavity  of  the  skull,  and  goes  to  the  external 
straight  muscle  of  the  eye. 

The  Seventh  Pair,  portio  mollis  (13),  is  distributed  upon  the  in- 
ternal ear. 

The  Eighth  Pair,  facial  nerve  (14),  is  distributed  over  the  face. 
It  sends  nervous  filaments  to  the  muscles. 

The  Ninth  Pair,  glosso-pharyngeal  nerve  (14),  passes  through  the 
same  opening  with  the  jugular  vein,  and  is  distributed  upon  the  mu- 
cous membrane  of  the  tongue  and  throat. 

The  Tenth  Pair,  pneumogastric  nerve  (15),  sends  its  branches  to 
the  pharynx,  larynx,  gullet,  lungs,  spleen,  pancreas,  liver,  stomach, 
and  bowels. 

The  Eleventh  Pair,  spinal  accessory  nerve  (16),  connects  with  the 
ninth  and  tenth  pairs,  and  is  distributed  to  the  muscles  of  the  neck. 

The  Twelfth  Pair,  h3q)o-glossal  nerve  (17),  goes  to  the  tongue, 
and  is  its  motion-producing  nerve.  It  is  a nerve  of  great  energy  in 
those  who  talk  much. 

The  Spinal  Cord  extends  from  the  medulla  oblongata,  where  it  is 
in  connection  with  the  brain,  down  to  the  second  lumbar  vertebra. 
The  upper  end  of  the  cord  presents  a bulbous  swelling,  or  enlarge- 
ment. Another  swelling  is  found  where  the  nerves  are  given  off 
which  go  to  the  upper  extremities ; and  a third  near  the  end  of  the 
cord,  where  the  nerves  begin  which  go  to  the  lower  extremities. 

Fissures  dip  into  the  cord  before  and  behind,  and  divide  it  into 
two  lateral  parts,  which  are  united  by  a thin  layer  of  white  substance. 

These  lateral  columns  are  divided  by  furrows  into  anterior^  lateral. 


52 


ANATOMY. 


and  posterior  columns ; — the  anterior  being  supposed  to  be  the  motor 
column,  the  posterior  that  of  sensation^  and  the  lateral  divided  in 
function  between  motion  and  sensation. 

The  5pinal  Nerves,  connecting  with  the  cord,  are  in  pairs,  of 
which  there  are  thirty-one.  Each  pair  has  two  roots,  — a motor  root, 

C,  Fig.  49,  arising 
from  the  anterior 
columns  of  the 
cord,  and  a sensi- 
tive root,  D,  spring- 
ing from  the  pos- 
terior columns.  A, 
is  a section  of  the 
cord,  surrounded 
by  its  sheath.  B, 
is  the  spinal  nerve, 
formed  by  the 
union  of  the  motor  and  sensitive  roots.  After  the  union,  the  nerve, 
with  its  motor  and  its  sensitive  filaments,  divides  and  subdivides 
as  it  passes  on,  and  is  distributed  to  the  tissues  of  the  several 
organs. 

The  thirty-one  pairs  of  spinal  nerves  are  divided  into  eight  pairs  of 
cervical^  twelve  pairs  of  dorsal^  five  pairs  of  lumbar,  and  six  pairs  of 
sacral  nerves. 

Fig.  50  gives  a view  of  the  brain  and  spinal  cord,  with  the  nerves 
given  off  by  the  latter:  1,  1,  being  the  two  hemispheres  of  the  brain; 
3,  3,  the  cerebellum ; 4,  the  olfactory  nerve ; 6,  the  optic ; 7,  the 
third  pair ; 8,  the  pons  varolii,  so  called  ; 9,  the  fourth  pair ; 10,  the 
lower  portion  of  the  medulla  oblongata;  11,  11,  the  spinal  cord;  12, 
12,  the  spinal  nerves ; 13,  13,  the  brachial  plexus ; 14,  14,  the  lum- 
bar and  sacral  plexus. 

The  Brachial  Plexus  is  formed  by  the  interlacing  of  the  four  lower 
cervical  and  upper  dorsal  pairs  of  nerves.  It  gives  off  six  nerves, 
which  are  distributed  to  the  muscles  and  skin  of  the  upper  extremi- 
ties. 

The  Lumbar  and  5acral  Plexus  is  formed  by  the  last  dorsal  and 
five  lumbar  nerves,  from  which  nerves  go  to  the  muscles  and  skin  of 
the  lower  extremities,  and  the  last  lumbar  and  four  sacral,  from 
which  nerves  are  sent  to  the  muscles  and  skin  of  the  hips  and  lower 
extremities. 

The  Sympathetic  Nerve  consists  of  a series  of  knots  (ganglia), 
lying  along  on  each  side  of  the  spinal  column,  and  forming  a knotted 
chain.  There  is  a knot  for  each  intervertebral  space,  the  neck  ex- 
cepted. These  knots  are  composed  of  both  cineritious  and  medullary 
matter. 


ANATOMY. 


53 


Each  knot  is  a distinct  centre,  and  gives  off  branches  upward, 
downward,  externally,  and  internally.  All  the  internal  organs  are 


Fig.  60, 


Fig.  61. 


supplied  with  branches  from  the  sympathetic  nerve.  It  is  called  the 
nerve  of  organic  life,  and  is  supposed  to 
preside  over  nutrition,  secretion,  etc.,  as  the 
nerves  of  the  brain  and  cord  preside  over 
motion  and  sensation. 

Fig.  51  is  a fine  representation  of  the 
great  sympathetic,  with  its  knots,  and  con- 
nections with  other  nerves.  A,  A,  A,  is 
the  semilunar  ganglion  and  solar  plexus, 
lying  just  under  the  diaphragm  and  behind  the  stomach.  Its  pres- 
ence in  this  region  is  the  reason  why  a blow  upon  the  pit  of  the 
stomach  sometimes  destroys  life.  D,  D,  D,  are  the  thoracic  ganglia ; 
E,  E,  the  external  and  internal  branches  of  the  same ; G,  F,  the 
right  and  left  coronary  plexus  upon  the  heart ; I,  N,  Q,  the  inferior, 
middle,  and  superior  cerArical  ganglia;  1,  the  renal  plexus  around  the 


Fig.  62. 


54 


ANATOMY. 


kidneys ; 2,  the  lumbar  ganglion ; 3,  the  internal  branches  ; 4,  the 
external  branches  ; 5,  the  aortic  plexus. 

Fig.  52  represents  a plexus,  showing  how  the  filaments  of  one 
nerve  pass  to  be  enclosed  in  the  sheath  of  another.  In  this  way  they 
change  at  once  the  direction  of  their  journey,  and  their  companions 
upon  the  way. 

The  Organs  of  Sight. 

The  organs  of  vision  are  the  optic  nerve,  the  globe  of  the  eye,  the 
muscles  of  the  eye,  and  the  organs  of  protection. 

The  Optic  Nerve  begins  by  two  roots  at  the  base  of  the  brain,  the 
fibres  from  which  meet,  as  they  come  forward,  and  some  of  them  cross 

each  other.  The  two  nerves  then  sepa- 
rate, and  enter  the  back  part  of  the 
globe  of  the  eyes,  and  then  spread  out 
into  a kind  of  membrane.  In  Fig.  53 : 
1,  1,  show  the  globe  of  the  eye  ; 2,  the 
crossing  of  the  optic  nerve ; 8,  the 
origin  of  two  pairs  of  cranial  nerves. 

The  Globe  of  the  Eye  is  a better 
constructed  optical  instrument  than 
man  ever  made.  Its  interior  is  filled 
with  what  are  called  refracting  humors 
or  mediums,  which  are  surrounded  and 
held  in  their  place  by  membranes,  called  coats. 

The  Coats  are  the  sclerotic  and  cornea  ; the  choroid,  iris,  and  ciliary 
processes  ; and  the  retina. 

The  Sclerotic  Coat  is  a fibrous  membrane,  covering  the  largest 
portion  of  the  globe.  To  this  the  muscles  are  attached.  It  is  the 
part  which  is  called  the  white  of  the  eye.  It  has  a beveled  edge  in 
front,  into  which  the  cornea  is  fitted. 

The  Cornea  is  a transparent  layer  which  projects  in  front,  and  forms 
about  one-fifth  of  the  globe.  It  is  shaped  like  a watch-glass.  Its 
blood-vessels  are  too  small  to  receive  the  red  particles  of  blood. 

The  Choroid  Coat  is  a vascular  membrane.  Its  color  is  brown  ex- 
ternally, and  black  within.  It  is  connected  with  the  sclerotic  coat 
externally,  and  internally  with  the  retina.  It  is  composed  of  three 
layers. 

The  Iris  is  named  from  its  having  a variety  of  colors  in  different 
persons.  It  is  the  partition  between  the  anterior  and  posterior  cham- 
bers of  the  eye,  and  has  a circular  opening  in  the  centre  called  the 
pupil.  Of  its  two  layers,  the  fibres  of  the  anterior  one  are  radiating, 
and  dilate  the  pupil,  while  those  of  the  other  are  circular,  and  cause 
its  contraction. 


ANATOMY. 


55 


The  Ciliary  Processes  are  a number  of  folds  formed  from  the  in- 
ternal layer  of  the  choroid  coat. 

The  Retina  has  three  layers.  The  external  is  extremely  thin  ; the 
middle  is  nervous,  being  an  expansion  of  the  optic  nerve  ; the  in- 
ternal is  vascular,  and  consists  of  a ramification  of  minute  blood 
vessels. 

The  divided  edge  of  their  coats  may  be  seen  in  Fig.  54,  namely, 
the  sclerotic,  the  choroid,  and  the  retina : 2,  is  the  pupil ; 3,  the 
iris ; 4,  the  ciliary  process ; 5,  the  scolloped  border  of  the  retina. 


64. 

The  Humors  of  the  Eye  are  the  aqueous,  the  crystalline,  and  the 
vitreous. 

The  Aqueous  or  watery  humor  is  situated  in  the  chambers  of  the 
eye.  It  is  an  albuminous  fluid,  with  an  alkaline  reaction,  and  a spe- 
cific gravity  a little  greater  than  distilled  water. 

The  Crystalline  Humor  is  immediately  behind  the  pupil.  It  is  a 
lens,  and  is  convex  both  on  the  posterior  and  the  anterior  surface. 

The  Vitreous  Humor  is  also  an  albuminous  fluid  something  like  the 
aqueous  humor,  but  more  dense. 

In  Fig.  55  we  have  in  E a good  view  of  the  cornea  fitted  into  the 
sclerotic  coat ; A,  is  the  choroid ; B,  the  pigmentum  nigrum , C, 
the  retina ; K,  the  vitreous  humor ; D,  the  optic  nerve ; I,  the  lens  c 
C,  the  Iris,  painted  on  the  backside  with  pigment;  F,  the  aqueous 
humor. 

The  muscles  of  the  eye,  six  in  number,  are  attached  to  the  bones 
of  the  orbit  behind,  and  to  the  cornea  in  front,  by  their  tendons. 
These  tendons  give  the  eye  its  pearly  appearance.  In  Fig.  56, 
five  of  the  muscles  are  indicated  by  a,  h,  c,  d,  e;  f,  is  the  optic 
nerve. 

If  the  internal  muscle  be  too  short,  the  eye  is  drawn  in  towards 
the  nose,  and  the  squinting  called  “ cross-eye  ” is  produced. 


56 


ANATOMY. 


The  Orbits  are  bony  sockets  which  enclose  the  eye.  The  optic 
nerve  passes  through  a large  hole  at  the  bottom. 

The  Eyebrows  are  the  projecting  arches  above,  covered  with  short 
hair.  They  prevent  the  sweat  from  running  down  into  the  eyes,  and 
also  shade  them  from  strong  light. 

The  Eyelids  are  the  curtains  which  rise  and  fall  in  front.  The 
smooth  membrane  which  lines  them  is  called  the  conjunctiva.  It 
secretes  a fluid  which  makes  the  eyelids  open  and  shut  easily. 


Fig.  56. 


The  Lachrymal  Gland  is  at  the  upper  and  outer  angle  of  the 
orbit.  Several  small  ducts  open  from  it  upon  the  upper  eyelid, 
through  which  the  tears  run  down  upon  the  conjunctiva. 

The  Lachrymal  Canals  begin  near  the  [internal  angle  of  the  eye, 
by  two  small-tear  points,  which  communicate  with  the  sac  at  the 
upper  part  of  the  nasal  duct. 

The  Nasal  Duct  is  a canal  about  three-quarters  of  an  inch  long, 
which  runs  down  to  the  inferior  channel  of  the  nose. 

Fig.  57  shows  these  organ  : 1,  being  the  lachrymal  gland  ; 2,  the 

ducts  leading  to  the  upper  eyelid;  3,  3,  the  tear-points  (puncta 
lachrymalis)  ; 4,  the  nasal  sac  ; 5,  the  termination  of  the  nasal  duct. 


Fig.  67. 


The  Organs  of  Hearing. 

The  External  Ear  is  composed  of  the  pavilion  of  the  ear  (the  pinna), 
and  the  auditory  canal  (the  meatus  auditorius  externus). 

The  Pinna  surrounds  the  entrance  to  the  auditory  canal.  It  stands 
out  from  the  head,  and  is  in  common  language  called  the  ear. 

The  rieatus  Auditorius  in  a canal  about  an  inch  long,  partly  bony 
and  partly  cartilaginous,  which  goes  from  the  pavilion  of  the  ear  to 
the  drum  of  the  ear. 

The  Drum  of  the  Ear  (membrana  tympani)  is  an  oval-shaped  thin 
membrane,  inserted  into  a groove  around  the  auditory  canal. 


ANATOMY. 


57 


The  Tympanum  is  a cavity  within  the  temporal  bone. 

The  Eustachian  Tube  is  a 

channel  of  communication  be- 
tween the  tympanum  and  the 
upper  part  of  the  pharynx. 

The  object  of  this  is  to  convey 
air  to  the  di’um  of  the  ear,  as 
without  air  no  sound  can  be 
produced. 

The  Labyrinth  is  a series  of 
chambers  through  the  petrous 
bone  — embracing  the  vestibule, 
a three-cornered  cavity  within 
the  tympanum ; the  semi-circu- 
lar canals,  communicating  with 
the  vestibule,  and  the  cochlea, 
which  makes  two  and  a half  turns  around  an  axis,  called  the 

modiolus. 

In  Fig.  58,  a,  is  the  pa* 
vilion  of  the  ear ; c,  the 
auditory  canal ; g,  the  mem- 
brana  tympani ; k,  the  tym- 
panum ; e,  the  bones  of  the 
ear;  h,  the  semicircular  ca 
nals  ; f,  the  cochlea;  A,  the 
vestibule  ; i,  the  eustachian 
tube ; d,  the  auditory  nerve. 

In  Fig.  69,  we  have  a 
view  of  the  labyrinth  laid 
open,  and  highly  magnified : 
1,  1,  being  the  cochlea ; 2, 
3,  the  channels  that  wind 
around  the  central  point 
(5)  ; 7,  7,  the  vestibule  ; 8, 
the  foramen  rotundum;  9, 
the  fenestra  ovalis ; 4,  6, 10,  the  semicircular  canals. 


HYGIENE 


Physiological  Laws  of  Life  and  Health 


It  is  absolutely  necessary  that  every  person  should  be  conversant 
with  Hygiene^  to  understand  the  laws  of  health. 


PHY8I0L0GICAI  LAWS  OF  LIFE  AND 
HEALTH.— HYGIENE. 


Life,  the  Infancy  of  Being. 

It  may  be  stated  as  a general  truth  that  man  has  but  just  learned 
to  live  when  he  is  ready  to  die.  We  expend  a large  portion  of  our 
lives  in  searching  out  our  mistakes,  and  in  striving  to  undo  the  mis- 
chiefs they  have  occasioned.  This  is  true  in  reference  both  to  our 
moral  and  our  physical  life  ; and  I draw  from  it  the  conclusion  that 
the  present  must  be  only  the  infancy  of  our  being,  and  that  our  blun- 
ders and  consequent  sufferings  here  will  cause  us,  in  the  great  here- 
after, to  place  a higher  value  upon  knowledge,  and  to  struggle  with 
new  fortitude  to  rid  ourselves  of  every  bondage. 

A life  which  has  just  begun  to  take  shape  and  symmetry,  cannot 
be  permitted,  I think,  under  the  rule  of  a benevolent  Creator,  to  be- 
come extinct.  We  shall  certainly  be  permitted  to  take  up  the  broken 
thread  of  life,  and,  in  the  clearer  light  of  the  future,  with  the  warning 
experience  of  the  past,  and  surrounded  by  better  guards,  to  try  again. 
In  the  meantime,  while  here,  the  sooner  we  become  acquainted  with 
the  laws  of  life,  and  the  better  we  obey  them,  the  more  we  shall  en- 

joy- 

The  Nervous  System. 

Man  is  brought  into  connection  with  the  outward  world  through 
the  senses  of  feeling,  seeing,  hearing,  etc.  These  communicate  with 
the  brain  and  mind  through  the  nerves  of  sensation. 

The  nervous  system  is  divided  into  two  great  central  portions, 
the  brain  and  the  spinal  cord ; and  these  together  are  called,  by  the 
learned,  the  cerebrospinal  centre.  There  are  numerous  pulpy  white 
cords,  called  nerves,  which  at  one  end  are  connected  with  this  great 
axis  or  centre,  and  from  thence  run  to  all  parts  of  the  system.  A 
portion  of  these  nerves  start  from  the  base  of  the  brain  and  run  to 
the  eye,  the  ear,  the  tongue,  etc.  (Fig.  48)  ; while  another,  and  a 
larger  part  spring  from  the  cord  which  runs  through  the  backbone, 
and  are  distributed  over  the  body  and  the  lower  extremities  (Figs. 
50  and  60).  One  portion  of  these  cords  produce  feeling ; another 
part,  motion.  The  former  we  call  sensitive  ; the  latter,  motor.  Both 
^nds  are  widely  distributed  over  the  body.  Those  which  spring 
from  the  spinal  cord  have  two  roots,  one  uniting  with  the  back,  the 


60 


HYGIENE. 


other  with  the  front  part  of  the  cord.  Cut  off  the  hack  root,  and  the 
part  to  which  it  is  distributed  loses  its  feeling.  As  we  say  in  com- 
mon language,  it  be- 
comes numh,  though  it 
may  move  as  well  as 
before.  Cut  the  front 
root,  which  is  motion- 
producing,  and  the  part 
to  which  it  goes  cannot 
move.  It  is  palsied^ 
though  it  may  still  feel 
acutely.  The  numerous 
nerves  that  spring  from 
the  spinal  column  are 
pretty  well  represented 
in  Fig.  60. 

If  the  cranial  nerves 
of  motion  which  go  to 
the  face  be  cut,  no  emo- 
tion or  passion  can  be 
expressed.  The  features 
will  all  be  immovable, 
like  statuary.  To  smile, 
to  laugh,  to  frown,  to 
give  expression  to  the 
feeling  of  pity,  or  an- 
guish, or  love,  is  alike 
impossible.  And  yet  a 
breath  of  air  upon  the 
face  will  \>q  felt  as  readi- 
ly as  before.  Paralysis, 
or  palsy,  as  it  is  called, 
partial  or  general,  is  the 
resultof  injuryuponfew 
or  many  of  these  motion- 
producing  nerves.  Neu- 
ralgia, tic  douloureux, 
etc.,  arise  from  some 
disease,  perhaps  inflam- 
mation, of  the  nerves  of 
sensation. 


Fig.  60, 


How  the  Mind  gets  Knowledge.  Everything  the  mind  knows 
of  the  external  world,  it  learns  through  the  the  organs  of  sense,  which 
communicate  with  it  through  these  nerves.  Thus,  the  nerves  are 
acted  on  by  external  agents,  and  then  they  act  on  the  brain  and  cause 
sensations.  When  the  hand  is  burned  , the  nerves  of  sensation  run 
with  the  intelligence  to  the  brain,  which,  quick  as  thought,  through 


Copyright,  by  Bradley  & Woodruff, 


1 

Copyright,  by  Bradley  & Woodruff. 


Copyright,  by  Bradley  & Woodruff, 


Ml-Y, 


g^ENTRIciF 


\t^ 

s\  ^■Ht  & 

W 

HL.  ^ 

}BS^  -j^H  V 

.( 


:-<5'..',--  "■■>;■ 


iUf-'V- 

m 


•i;  -.• 

■•^',  - V ■■  ■ 


, V '•■•• 

, - ■ ' “Sv'  ■ 


f ■ ' ,t: 


, A ■-'"  . 

■■  . . 


K < 


,-■■■'  : ■ A ' •'  ■ ■'■■ 


HYGIENE. 


61 


the  nerves  of  motion,  despatches  orders  to  the  muscles  to  repel  the 
injury. 

Comparison.  — The  arrangement  and  operation  of  the  nervous 
system  are  like  those  of  the  electric  fire-alarm  system  of  a city. 
The  brain  is  the  intelligent  centre,  like  the  central  office.  The 
nerves  of  sensation  which  carry  to  the  brain,  with  electric  speed, 
intelligence  of  what  is  going  on  outside,  are  like  the  wires  which  run 
to  the  central  station  from  the  several  boxes.  The  quick  carry- 
ing to  the  brain  of  any  information  of  injury  done  to  some  part  of 
the  body,  is  like  sending  to  the  central  station  from  an  alarm-box 
the  intelligence  of  fire  in  one  of  the  districts.  The  rapid  transmis- 
sion of  orders  from  the  mind  to  the  muscles  is  like  flashing  the  alarm 
over  the  wires  to  every  part  of  the  .-ity.  And,  finally,  the  powerful 
action  of  the  muscles  in  warding  oh’  danger  is  like  the  dashing  of 
firemen  over  the  pavements  and  the  energetic  playing  of  the 
engines. 

Sensations. 

An  effect  produced  on  the  mind  through  a nerve  is  called  a 
sensation.  Hunger  is  a sensation.  It  is  an  effect  produced  upon  the 
mind  through  a certain  nerve  by  the  condition  of  the  stomach. 
Thirst,  pain,  heat,  cold,  are  sensations  in  a similar  sense.  Nausea 
is  a sensation  produced  by  some  injurious  substance  acting  upon  the 
coats  of  the  stomach. 

Strength  of  Sensation.  — Some  sensations  are  much  stronger 
than  others;  some  are  very  intense.  A very  strong  sensation  is 
called  a feeling.  It  is  common  to  say,  “I  feel  cold,”  or,  “I  feel  hot.” 
We  simply  mean  by  this,  that  the  temperature  of  the  weather  makes 
a very  powerful  impression  upon  us. 

Kinds  of  Sensation. — Sensations  are  either  pleasurable  or  pain- 
ful. Pleasurable  sensations  arise  from  the  proper  exercise  of  some 
healthy  part  of  the  body ; and  they  are  a suitable  reward  for  any 
care  the  mind  may  take  of  the  corporeal  organs. 

The  sensations  arising  from  a proper  amount  of  exercise  are 
pleasurable.  The  muscles  find  a sort  of  enjoyment  in  action.  He 
who  leads  a sedentary  life,  either  from  choice  or  necessity,  loses  much 
enjoyment.  Hence,  there  is  pleasure  in  labor ; and  the  working-man, 
though  often  pitied  by  the  wealthy,  is  generally  the  happiest  of  men. 
The  eye  and  the  ear,  when  directed  to  agreeable  sights  and  sounds, 
derive  the  most  agreeable  sensations  from  exercise.  The  air  of  a 
beautiful  spring-morning  gives  impressions  which  none  can  describe, 
but  which  all  know  to  be  delightful.  These  impressions  are  well 
fitted  to  reward  us  for  taking  at  that  season,  in  the  open  air,  the  ex- 
ercise we  so  much  need. 

Moral  Uses  of  Sensations.  — How  little  we  reflect  upon  the 
amount  of  happiness  it  is  in  our  power  to  create  by  making  agreeable 


62 


HYGIENE. 


impressions  upon  others.  A civil  and  polite  address  makes  a pleasant 
impression.  A kind  word,  fitly  spoken,  makes  the  heart  glad.  Heads 
of  families  might  do  much  to  increase  the  happiness  of  their  domes- 
tics in  the  kitchen  by  meeting  them  with  a pleasant  countenance,  and 
dropping  in  their  ear,  now  and  then,  a word  of  approval.  Such  little 
acts  of  benevolence  are  easily  performed,  and  they  make  the  most 
agreeable  and  lasting  impressions  upon  persons  in  the  lower  stations 
of  life,  — creating  attachments,  in  fact,  which  end  only  with  death, 
and  which  in  hours  of  future  sorrow,  which  come  to  all,  may  refresh 
us  like  springs  of  water  in  the  desert. 

“ Full  many  a shaft  at  random  sent, 

Finds  marks  the  archer  little  meant; 

Full  many  a word  at  random  spoken. 

May  heal  a wounded  heart  that’s  broken.” 

Sib  Walter  Scott. 

In  aiming  to  make  agreeable  impressions  upon  domestics,  we  should 
be  governed  by  the  simple  desire  to  create  happiness.  Their  sources 
of  happiness  are  comparatively  fevv^.  They  spend  their  days  below 
stairs, — shut  out  from  a portion  of  the  light  of  day,  and  from  the 
refining  influences  of  the  drawing-room,  — having  little  time  for  rest 
or  for  recreation.  How  unfeeling  to  treat  such  persons  with  harshness, 
to  wear  a frowning  face  in  their  presence,  and  thus  wither  the  few 
flowers  of  happiness  which  bloom  around  them ! 

Every  human  being  is  endowed  with  the  beautifu’  nervofls  organ- 
ism of  which  I have  spoken,  and  is  daily  receiving  impressions,  pleas- 
urable or  painful,  from  thousands  of  sources.  In  all  the  relations  of 
life,  it  should  be  our  aim  to  touch  delicately  this  sensitive  structure. 
Wives  may  add  much  to  the  happiness,  and  I may  say,  to  the  affec- 
tion of  their  husbands,  by  always  wearing  a pleasant  face ; and  the 
heart  of  the  wife  may  be  made  light  and  glad  by  gentle  words  from 
the  husband.  We  cannot  but  love  those  who  make  pleasurable  im- 
pressions upon  us,  and  we  necessarily  dislike  such  as  impress  us  pain- 
fully. Most  of  the  coldness  and  alienations  which  grow  up  between 
the  heads  of  families,  spring  from  the  habit  of  one  of  the  parties,  of 
saying,  or  doing,  or  looking  something  which  painfully  impresses  the 
other.  A woman  who  habitually  wears  a “sour  ” face  cannot  be 
loved  either  by  her  husband  or  her  children.  The  man  or  the  woman 
who  desires  to  be  loved,  must  cultivate  a manner,  a look,  a speech,  a 
life,  the  whole  scope  of  which  is  fitted  to  make  pleasurable  impres- 
sions upon  others.  It  is  against  nature  to  love  what  gives  us  pain. 

Agreeable  Sensations  a Source  of  Health.  — Pleasurable  sensa- 
tions not  only  beget  love,  and  increase  happiness,  but  they  add  much 
to  health.  They  exhilarate  the  spirits  and  drive  away  melancholy. 
TravelKng  promotes  health  and  prolongs  life,  by  the  number  and 
variety  of  the  pleasing  impressions  it  makes  upon  the  mind. 

Care  of  the  Sick. — If  the  above  statements  be  con-ect,  how  im- 
portant that  the  sick  should  be  so  dealt  with  as  to  have  none  but 


HYGIEKE. 


68 


agreeable  sensations  made  upon  them.  Many  a life  has  been  sacri- 
ficed to  the  peevish  temper  of  a nurse.  When  the  nerves  are  weak 
from  disease,  even  slight  causes  make  powerful  impressions  ; and  if 
these  impressions  are  of  a painful  kind,  the  results  are  most  deplora- 
ble. To  treat  harshly  the  sick,  especially  those  whose  nervous  system 
is  broken,  implies  either  great  thoughtlessness  or  extreme  cruelty.  A 
single  harsh  word,  which  would  scarcely  move  one  when  well,  may 
send  the  same  person,  when  sick,  almost  to  distraction.  Every  word 
spoken  to  persons  in  sickness  should,  therefore,  be  gentle  and  sooth- 
ing. Every  feature  of  the  face  should  express  either  cheerfulness, 
or  tenderness  and  pity. 

As  the  painful  impressions  which  disease  is  making  tends  to  de- 
press the  spirits  and  create  melancholy,  it  is  not  expected  that  persons 
when  sick  will  exhibit  as  amiable  tempers  as  when  well ; and  for 
this  all  due  allowance  must  be  made. 

Effect  upon  the  Disposition.  — This  leads  me  to  say  that  pleasur- 
able sensations  improve  the  temper  and  disposition.  This  is  a fact  of 
very  great  importance,  and  parents  should  never  lose  sight  of  it  in 
dealing  with  their  children.  There  are  few  children  but  would  grow 
up  amiable  and  useful  members  of  society,  were  they  dealt  with  in 
the  gentle  and  tender  manner  which  their  young  and  impressible 
natures  require.  From  the  moment  the  young  mind  wakes  to  intelli- 
gence, it  will  be  occupied  with  something.  Parents  and  guardians 
should  aim,  therefore,  to  turn  it  to  all  those  things  which  will  impress 
it  pleasantly,  and  at  the  same  time  do  it  no  harm.  Exercise,  songs, 
playthings,  flowers,  — to  these  and  other  entertainments  it  should  be 
led  by  gentle  hands.  No  thoughtful  parent  will  ever  pain  a child 
by  harsh  threats  and  denunciations,  or  shock  it  by  an  oath. 

Bad  Effect  of  Unpleasant  Sensations; — If  pleasurable  sensations 
improve  the  health  and  temper,  unpleasant  ones  do  just  the  opposite. 
They  break  down  the  health  and  spoil  the  disposition. 

They  are  intended  to  give  us  a warning  of  impending  injury. 
Thus,  we  have  painful  sensations  when  we  have  overworked  the  body 
or  mind.  The  sensation  of  weariness  tells  us  that  the  muscles  have 
worked  as  long  as  their  good  requires,  and  that  they  need  rest.  Were 
this  sensation  unheeded,  exhaustion  and  entire  prostration  would  be 
the  result. 

When  fatigue  begins  to  be  felt,  either  of  body  or  mind,  the  sensa- 
tion may  be  dissipated  by  strong  tea,  or  intoxicating  drink,  or  opium ; 
but  to  drive  it  away  in  this  manner,  for  the  purpose  of  working  longer, 
is  wrong,  and  leads,  in  the  end,  to  disease  or  exhaustion.  It  was  said 
that  one  of  the  most  brilliant  advocates  of  recent  times  was  dependent 
upon  opium  for  the  stimulus  to  carry  him  through  his  extraordinary 
flights  of  eloquence;  but  his  restless  motion  and  nervous  face  reminded 
one  that  he  had  bent  his  bow  very  nearly  to  the  snapping  point,  and 
that  a sudden  collapse  of  his  vital  powers,  at  no  distant  day,  might 
be  feared  as  the  result  of  such  tension. 


64 


HYGIENE. 


Persons  in  affliction,  whose  spirits  are  aepressed  and  broken  by 
sorrow,  should  have  their  thoughts  turned  away  from  all  sombre  ob- 
jects and  contemplations.  They  should  be  taken  into  the  open  sun- 
light, and  be  diverted  by  the  beautiful  things  of  nature.  They 
should  visit  cheerful  society,  and  open  their  hearts  to  pleasurable  im- 
pressions. 

When  we  permit  any  part  of  the  body  to  remain  idle,  neglecting 
to  use  it  as  much  as  we  ought,  unpleasant  sensations  remind  us  of 
our  fault.  The  muscles,  when  unused,  waste  away  and  become 
feeble.  This  is  sure  to  produce  an  uneasy,  nervous  state  of  feeling, 
which  says  to  us  as  plainly  as  a sensation  can,  that  the  muscles  are 
hungry  for  exercise,  and  that  it  is  injurious  to  let  them  rest  longer. 

Need  of  a Healthy  Brain.  — In  order  that  we  may  get  correct 
ideas  of  the  external  world,  it  is  necessary  that  the  brain,  the  nerves,  and 
the  organs  of  sense  through  which  sensations  are  made  upon  the 
mind,  should  be  in  a healthy  condition.  It  is  evident  that  if  the  in- 
struments of  sensation  be  diseased,  the  sensation  cannot  be  natural, 
and  will  make  a false  report  to  the  mind.  It  is  of  the  highest  im- 
portance, therefore,  that  the  brain  should  be  sound. 

Improper  Intermarriages.  — This  organ,  like  every  other,  may 
inherit  disease  from  parents.  Insanity,  which  springs  from  a dis- 
eased brain,  is  often  hereditary.  When  both  parents  are  diseased, 
the  offspring  are  of  course  more  liable  to  partake  of  their  defects. 
Among  the  wealthy,  and  particularly  among  the  royal  families  in 
Europe,  nervous  diseases  and  sterility  are  very  common.  This 
arises,  in  a great  part,  from  intermarriages  among  blood  relations,  — a 
practice  under  wliich  any  people  will  degenerate,  and  finally  perish. 
The  wisdom  of  the  Old  Testament  prohibition  of  marriage  within 
certain  degrees  of  consanguinity  has  been  established  by  the  obser- 
vation of  pliilosophers  and  the  experience  of  mankind.  Let  those 
who  will  transmit  to  their  descendants  a sound  mind  in  a sound 
body,  observe  the  laws  of  life,  and  avoid  all  marriages  with  blood 
relations. 

Need  of  a Good  Supply  of  Blood. — For  a proper  performance 
of  its  duties,  the  brain  requires  and  receives  a larger  supply  of  blood 
than  any  other  part  of  the  system.  One-tenth  of  all  the  blood  goes 
to  this  important  organ.  If  the  quantity  or  quality  be  materially 
lessened  or  changed,  great  disturbance  of  the  brain  follows.  A large 
loss  of  blood  occasions  dizziness  and  fainting.  If  an  atmosphere 
charged  with  too  much  carbonic  acid  gas  be  breathed,  as  in  a deep 
well,  the  blood  is  not  vitalized  in  the  lungs,  so  as  to  sustain  the 
brain,  and  unconsciousness  soon  follows.  If  the  air  be  vitiated  in 
any  way,  or  have  its  oxygen  extracted,  as  in  large  assemblies,  where 
it  is  breathed  over  several  times,  it  becomes  unfit  to  support  the 
brain,  and  the  result  is  languid  feelings,  inability  to  apply  the  mind, 
headache,  fainting,  hysterics,  and  other  nervous  manifestations. 


HYGIENE. 


65 


Ventilation.  — This  shows  the  great  necessity  of  having  dwellings, 
churches,  and  school-houses  well  ventilated. 

Were  a good  system  of  ventilation  adopted  in  all  our  churches, 
ministers  would  seldom  preach  to  sleeping  audiences.  A congrega- 
hon  sitting  in  one  of  our  places  of  public  worship,  where  the  air  in 
,1  single  afternoon  is  as  many  times  used  over  as  the  minister’s  ser- 
jaons  are  in  a lifetime,  can  neither  hear  with  attention,  nor  compre- 
hend with  clearness. 

In  many  of  our  school-houses,  the  ventilation  is  quite  as  bad,  and 
the  consequences  worse,  because  they  are  occupied  six  hours  of  the 
day  instead  of  three,  and  five  days  of  the  week  in  place  of  one.  In 
the  small  school-houses  which  our  children  filled  to  overflowing  in 
former  years,  in  which  there  was  no  ventilation,  unless  they  happened 
to  be  blessed  with  an  old-fashioned  chimney  and  fire-place,  the  effects 
upon  the  nervous  system  of  the  children  was  deplorable.  Many  of 
the  diseases  which  afflict  the  present  generation  of  men  and  women 
had  their  origin  in  the  bad  air  of  those  crowded  nurseries  of  edu- 
cation. 

Our  dwellings  were  partly  ventilated  in  olden  time,  when  the 
open  fire-place  received  the  “ back -log,”  the  “ top-stick,”  the  “ fore- 
stick,” and  other  sticks  to  match ; but  since  we  have  been  warmed 
by  the  stove  and  the  furnace  we  have  known  little  of  the  luxury  of 
pure  air  at  the  domestic  hearth. 

Need  of  Exercise  for  the  Brain.  — Health  requires  that  the 
brain  should  be  properly  occupied  with  vigorous  thought.  The 
same  reasons  may  be  given  for  this  as  for  the  exercise  of  the  muscles. 
It  is  governed  by  the  same  laws  which  apply  to  other  parts  of  the 
system.  Use  improves  its  strength  and  vigor ; idleness  causes  it  to 
grow  feeble.  Of  course  the  labor  it  is  put  to  should  be  only  reason- 
able in  amount,  and  should  not  be  too  long  continued  at  any  one 
time.  With  the  weakening  of  the  brain,  the  whole  bodily  forces, 
and  indeed  the  whole  mental  and  moral  character,  fall  into  feebleness 
and  decay.  It  is  a great  mistake  to  suppose  that  the  cultivation  and 
even  vigorous  use  of  the  mind  impairs  health  and  shortens  life. 
Just  the  opposite  is  true.  Many  of  the  most  eminently  intellectual 
men,  who  have  worked  their  brains  hard  all  their  lives,  have  been 
distinguished  for  long  life. 

Bad  Effect  of  Change  in  Circumstances.  — No  class  of  persons 
suffer  more  from  nervous  diseases  and  general  ill-health  than  those 
who,  having  worked  hard  in  early  life,  with  little  or  no  cultivation 
of  the  mind,  are  suddenly  raised  to  wealth,  and  immediately  drop  all 
exercise,  and  fall  into  habits  of  indolence  and  luxury.  The  condition 
of  such  persons  would  be  much  less  pitiable,  did  they  take  up  books 
when  they  lay  by  the  hoe  or  the  broom.  But  they  seldom  do  this.  Many 
a woman,  in  early  life,  has  felt  the  glow  of  health  in  every  limb, 
and  a thrill  of  pleasure,  too,  while  scrubbing  the  floor  on  her  hands 


66 


HYGIENE. 


and  knees,  who  has,  in  subsequent  years,  reclined  in  misery  upon 
her  damask-covered  lounge,  and  wondered  that  she  could  not  have 
the  health  of  other  days.  Let  her  cultivate  her  brain,  live  temper- 
ately, and  exercise  in  the  open  air,  and  life  may  again  have  real 
pleasures  for  her. 

Discretion  in  Exercising  the  Brain In  exercising  the  brain 

we  must  use  discretion.  We  must  not  sit  down  in  the  morning,  and 
ply  it  with  work  during  the  whole  day,  without  rest.  This  would 
soon  bring  upon  it  disease,  or  premature  decay.  It  should  be  worked 
only  until  it  begins  to  show  symptoms  of  fatigue.  Then  it  should  be 
permitted  to  rest ; or,  what  is  better,  be  turned  to  some  new  subject,  of 
a lighter,  or  a different  character.  This  often  rests  the  brain  better 
than  to  entirely  suspend  its  action. 

Overworking  the  Brain  in  Childhood. — Great  care  should  be 
used  not  to  exercise  the  brain  too  much  in  early  life.  Like  other 
parts  of  the  system,  it  is  tender  in  childhood,  and  will  not  bear  pro- 
longed exertion.  As  a general  thing,  children  are  put  to  school  too 
early,  and  made  to  work  their  brains  too  hard.  Great  mischief  arises 
from  this  source.  Children  are  born  with  larger  brains  now  than 
formerly ; and  it  is  no  uncommon  thing  to  see  upon  a child  of  ten 
years,  a head  equal  in  size  to  that  of  an  adult.  Children  run  to 
Drain.  Precocity  in  development  of  brain  and  mind  is  common. 
The  results  of  stimulating  and  hastening  the  unfolding  of  such  minds 
are  deplorable.  In  such  children,  the  brain  should  be  the  last  thing 
to  be  cultivated.  We  do  not  need  to  urge  its  growth.  It  will  come 
forward  fast  enough  in  spite  of  us.  Our  chief  aim  should  be  to  harden 
and  fortify  the  general  constitution,  so  that  the  brain  which  it  is 
required  to  bear  up  and  sustain  may  long  be  its  crown  and  glory. 

Yet  parents  are  proud  of  their  precocious  children,  and  often  re- 
verse this  rule.  They  do  it  thoughtlessly,  and  would  be  terribly 
startled  could  they  suddenly  look  into  the  future  and  see  the  results 
of  their  folly.  Could  they  do  so,  they  would  see  inflammation  and 
softening  of  the  brain,  epilepsy,  insanity,  paralysis,  apoplexy,  with  all 
the  horrors  of  undescribed  and  indescribable  nervous  affections,  which, 
though  without  a name,  have  a terrible  reality. 

Old  People’s  Brains.  — Persons  in  advanced  life  should  be  par- 
ticularly careful  not  to  overwork  the  brain.  In  middle  life  it  re- 
covers easily  from  great  fatigue.  In  the  decline  of  life,  its  powers 
of  recovery  are  feeble.  A single  exhaustion  may  cause  its  fatal  col- 
lapse. Old  age  should  be  distinguished  for  gentleness  and  modera- 
tion. The  journey  of  the  down-hill  of  life  should  be  made  by  short 
and  easy  stages,  through  regions  of  diversified  beauty. 

A Supply  of  Blood.  — Every  part  of  the  system,  when  hard  at 
work,  needs  and  must  have  a very  large  supply  of  pure  blood. 
Without  this,  it  is  torpid  and  inactive.  To  cause  the  blood  to  flow 
to  any  particular  part,  it  must  be  exercised.  The  lumberman,  when 


Physicians  Publishing  Co.,  Boston,  Mass. 


SCIATIC 


POPLITEAL 


BASE  OF  BRAIN 


BRACH  lAL 
PLEXUS 


ULNAR 


RADIAL 


BRAIN 


CERVICAL  7 NERVES 


POST  TiBIAL 


DORSAL  12  NERVES 


LUMBAR  5 NERVES 


SACRAL  LOWER 

5 NERVES 


NERVES  OF  THE  HUMAN  BODY 


HYGIENE. 


67 


in  the  forest  in  extreme  cold  weather,  stamps  his  feet  violently  upon 
the  ground,  or  beats  them  against  a log,  and  whips  his  hands  around 
his  body,  and  in  this  way  makes  them  red  and  warm  with  a new 
supply  of  blood.  The  stomach,  when  it  has  received  a supply  of 
food,  begins  earnestly  to  turn  it  over ; and  by  this  exercise,  and  the 
stimulus  which  the  food  supplies,  it  invites  large  quantities  of  blood 
to  its  vessels,  and  thus  increases  its  power  to  work.  But  just  in 
proportion  that  it  draws  the  vital  current  to  itself ^ and  augments  its 
own  vital  force,  it  diminishes  the  blood  in  other  organs,  and  for  the 
time  being,  unfits  them  for  work.  The  same  may  be  said  of  the 
brain  and  all  other  working  organs. 

From  this  it  follows  that  only  one  organ,  or  set  of  organs,  can 
work  effectively  at  the  same  time,  and  that  it  is  improper  to  put  the 
brain  to  hard  work  immediately  after  a full  meal,  because  the 
stomach  then  wants  the  blood  to  enable  it  to  digest  the  food ; and  if 
the  blood  be  called  off  to  the  brain,  digestion  will  stop.  Nor  should 
the  stomach  be  loaded  with  food  directly  after  long  and  hard 
thinking ; for  the  brain  will  yield  up  the  blood  to  it  only  after  its 
own  excitement  has  had  time  to  subside. 

Sympathetic  Nervous  System. 

Tbte  object  of  this  system  seems  to  be  to  bind  all  parts  of  the 
body  together,  and  to  combine  and  harmonize  their  actions.  It  takes 
care  that  no  part  of  the  system  acts  in  such  a way  as  to  injure  any 
other  part.  It  exerts  a controlling  influence  over  digestion,  nutrition, 
absorption,  the  circulation,  etc.  These  are  natural  processes  which 
need  to  go  on  while  the  brain  is  asleep  and  cannot  attend  to  them. 
The  nervous  system,  of  which  I speak,  presides  over  all  those  func- 
tions which  are  called  involuntary,  — so  called  because  no  act  of  the 
will  is  needed  for  their  performance.  Secretion,  absorption,  digestion, 
and  the  circulation  of  the  blood,  all  have  to  go  on  while  we  sleep,  as 
well  as  while  we  wake.  Were  an  act  of  the  will  necessary  to  their 
performance,  as  in  walking,  eating,  conversing,  etc.,  then  they  would 
have  to  cease  the  moment  the  brain  fell  asleep,  and  death  would  be 
the  result. 

The  sympathetic  nerves  apprise  each  part  of  the  system  of  the 
condition  and  wants  of  every  other  part.  When  the  lungs  are  in- 
flamed, the  stomach  seems  to  be  aware  of  it,  and  will  receive  no  food, 
because  this  would  aggravate  the  disease  of  the  neighboring  organs. 
Well  would  it  be  if  human  beings  would  exercise  a like  forbearance, 
and  abstain  from  those  acts  of  self-gratification  which  they  know  will 
injure  their  neighbors. 

Effects  of  Nervous  Diseases.  — Before  closing  these  observations, 
I wish  to  add  a few  words  respecting  the  terrible  effects  of  nervous 
diseases  which  characterize  the  present  time. 

That  they  are  far  more  numerous  and  afiSictive  than  in  former 


68 


HYGIENE. 


years,  must  be  apparent  to  the  most  careless  observer.  They  are 
nothing  more  nor  less  than  the  price  we  pay  for  a high  civilization, 
and  especially  for  our  democracy.  Among  us,  every  man  feels  his 
individuality,  and  has  a motive  for  thinking  and  doing  his  best. 
Thought  and  action  are  here  unfettered ; and  if  the  race  is  not  to 
the  swift,  nor  the  battle  to  the  strong,  every  man  acts  as  though  he 
thought  it  was.  The  great  excitement  which  the  struggle  for  wealth 
kindles  and  inflames,  deranges  and  shatters  the  nervous  system  to  a 
shocking  degree. 

And  wealth,  when  obtained,  does  its  full  share  to  weaken  the 
nerves.  It  brings  with  it  high  living,  indolence,  loss  of  energy,  dis- 
sipation, and  a weakening  of  the  whole  moral  and  physical  powers. 
It  need  not  do  this ; but,  in  most  cases,  it  does. 

The  result  is,  that,  at  least,  every  other  person  has  some  nervous 
disease,  which  makes  life  a misery  rather  than  a blessing.  The  brain 
and  nerves  are  too  much  developed  in  comparison  with  the  develop- 
ment of  the  muscles.  Half  our  boys  and  girls  have  heads  as  large 
as  men  and  women.  It  is  common  to  see  a boy  or  a girl  at  ten  talk- 
ing and  acting  like  a man  or  woman.  I do  not  mean  by  this,  that 
they  imperfectly  imitate  the  actions  of  older  persons.  It  seems  to  be 
natural  to  them.  Their  brains  are  prematurely  developed,  and  their 
acts  and  thoughts  have  the  maturity  of  adult  life. 

What  is  Coming?  — What  will  be  the  result  of  this  state  of 
things,  no  man  can  predict.  I sometimes  think  the  race  will  break 
down  ; that  that  which  was  intended  to  be  its  ornament  and  strength 
will  be  its  destruction.  I hope  not.  Yet  there  is  danger  of  it. 
Nothing  can  save  us  but  the  wisdom  to  adopt  such  means  as  will 
develop  all  parts  of  the  system  alike.  No  race  of  men  can  stand  for 
many  generations  such  a strain  upon  the  nervous  system,  unless  bet- 
ter means  are  adopted  to  counterbalance  its  evil  effects  than  are  now 
used  in  the  United  States.  We  have  got  to  pause  in  our  swift 
career,  and  look  after  our  health,  or  we  shall  become  a nation  of 
maniacs.  No  proof  is  needed  of  what  is  here  said. 

Hopeful  Considerations.  — It  is  proper  to  say,  the  considerations 
here  presented,  terrible  as  they  are,  are  mitigated  in  some  measure  by'" 
others  of  a more  hopeful  character. 

Physiology  and  the  laws  of  life  are  now  better  understood  than  at 
any  former  period.  These  subjects  are  getting  into  our  common 
schools,  and  are  engaging  the  attention  of  our  youth.  Declining 
health  has  already  made  us  think  more  of  the  means  of  preserving 
it,  — such  as  diet,  exercise,  bathing,  travelling,  and  amusement.  To 
encourage  and  intensify  this  hopeful  direction  of  the  public  mind,  I 
propose  to  devote  a few  pages  to  these  subjects. 


HYGIENE. 


G9 


Food  and  Digestion. 

Fbom  the  earliest  dawn  of  existence  to  the  last  moment  of  life,  our 
bodies  are  constantly  changing.  Old  particles  of  matter,  when  they 
are  worn  out,  leave  their  places  and  are  thrown  out  of  the  system. 
Were  this  the  whole  of  the  matter,  our  bodies  would  soon  waste 
away,  and  that  would  be  the  end  of  us.  But  as  fast  as  the  old  mate- 
rials are  thrown  away,  new  ones  take  their  places ; and  it  is  solely 
out  of  our  food  that  these  new  materials  are  formed. 

In  order  that  the  food  may  be  well  digested,  it  must  first  be  broken 
into  small  particles  in  the  mouth.  The  act  of  chewing  it  is  called 
mastication.  During  this  act,  if  it  be  well  performed,  a large  quan- 
tity of  spittle,  called  saliva,  flows  out  of  a number  of  glands,  called 
salivary  glands,  and  mixes  with  the  food,  forming  with  it  a soft  mass. 
In  this  condition,  it  is  thrown  backward  into  the  top  of  the  throat, 
called  the  pharynx.  Here,  a little  cartilage,  called  the  epiglottis, 
drops  down  upon  the  opening  into  the  top  of  the  windpipe,  and  pre- 
vents its  entrance  into  the  breath-passage ; and  it  is  pushed  along 
into  the  gullet,  a tube  which  runs  down  behind  the  windpipe  and 
lungs,  and  which  physicians  call  the  oesophagus.  Here  a succession 
of  muscular  bands,  circular  in  shape,  contract  upon  it,  one  after 
another,  and  force  it  down  into  the  stomach. 

It  is  important  that  two  things  should  be  secured  while  the  food  is 
in  the  mouth,  namely,  that  it  should  be  reduced  to  a good  degree  of 
fineness  by  chewing,  and  that  a proper  amount  of  saliva  should  be 
mixed  with  it.  If  the  chewing  were  not  necessary,  teeth  would  not 
have  been  given  us ; and  the  salivary  glands  would  certainly  not  have 
been  put  in  the  mouth,  if  the  mixing  of  water  with  our  food  would 
serve  the  purposes  of  digestion  as  well. 

Eating  too  Rapidly. — Americans  have  fallen  into  a pernicious 
error  in  eating  their  food  too  rapidly.  Time  is  not  given  to  chew  it 
sufficiently  to  excite  a full  flow  of  saliva ; and  as  it  cannot  be  swal- 
lowed in  a dry  state,  it  is  not  uncommon  to  see  persons  taking  a sip 
of  water  after  every  second  mouthful,  to  enable  them  to  force  it  into 
the  stomach.  It  is  a habit  we  Americans  have  of  cheating  ourselves 
both  of  the  pleasures  and  the  benefits  of  eating ; for  the  only  real 
pleasure  of  eating  arises  from  the  flavor  of  food  while  retained  in  the 
mouth,  and  the  only  benefit  we  can  derive  comes  in  consequence  of 
its  proper  digestion. 

The  food  when  received  into  the  stomach  is  in  the  same  condition 
as  when  taken  into  the  mouth,  except  that  it  is,  or  should  be,  ground 
fine  by  the  teeth,  and  well  mixed  with  saliva. 

The  Gastric  Juice.  — The  stomach,  like  the  mouth,  the  windpipe, 
and  the  gullet,  is  lined  by  a mucous  membrane.  The  chief  office  of 
this  membrane  is  to  secrete,  or  take  out  of  the  blood,  a fluid  which 
we  call  gastric  juice,  which  means  stomach  juice,  from  the  Greek 


70 


HYGIENE. 


name  of  stomach,  yaa-rep  (gaster).  This  fluid  has  not  much  smell 
or  taste,  and  looks  like  spring  water.  It  has  a powerful  effect  upon 
food,  which,  when  mixed  with  it,  soon  undergoes  an  important 
change,  which  is  apparent  to  the  taste,  the  smell,  and  the  sight.  The 
nature  of  the  gastric  juice  and  how  it  produces  its  effect  upon  food 
are  not  certainly  known ; but  it  contains  two  active  elements,  — a 
free  acid  and  pepsin,  whose  function  is  to  dissolve  the  nitrogenous 
parts  of  the  food  and  convert  them  into  albuminose  or  peptone.  The 
albuminose  is  absorbed  by  the  coats  of  the  stomach  and  enters 
directly  into  the  circulation  ; while  the  sugar  and  fat  pass  on  to  the 
duodenum  to  be  acted  upon  by  the  bile,  the  pancreatic  juice,  and 
other  secretions  of  the  bowels. 

Too  Much  Cold  Water  at  Meals.  — There  are  some  interesting 
facts  connected  with  the  formation  of  this  fluid,  of  which  it  is  im- 
portant that  every  person  should  be  apprised. 

Its  quantity  and  quality  depend  on  the  amount  and  healthfulness 
of  the  blood  which  flows  to  the  stomach  during  the  first  stage  of 
digestion.  It  is,  therefore,  injurious  to  drink  large  quantities  of  very 
cold  water  with,  or  immediately  after,  our  meals  ; as  this  will  chill 
the  stomach,  and  repel  the  blood  from  its  vessels,  so  that  but  little 
of  the  juice  can  be  formed.  Digestion,  in  such  case,  must  be  im- 
perfect. 

This  Fluid  not  Secreted  Without  Limit. — This  fluid  does  not 
flow  into  the  stomach  continuously,  but  only  when  we  swallow  food, 
and  then  not  as  long  as  we  please  to  eat,  but  merely  till  we  have  taken 
what  the  system  requires.  If,  in  the  amount  we  take,  we  go  beyond 
the  wants  of  nature,  there  will  not  be  fluid  enough  formed  to  dissolve 
it,  and  the  whole  will  be  imperfectly  digested,  and  be  a source  of  in- 
jury rather  than  benefit.  This  should  teach  us  to  be  careful  that  our 
food  be  only  reasonable  in  amount. 

Not  Secreted  in  Sickness.  — When  we  are  sick,  the  gastric  juice 
is  either  not  formed  at  all,  or  only  in  small  quantities.  Whatever 
may  be  our  feelings  of  lassitude,  and  however  much  we  may  appear 
to  need  food,  at  such  times,  it  is  useless  to  take  it,  for  it  cannot  be 
digested,  and  will  only  aggravate  our  disease.  If  the  illness  be  only 
slight,  the  fluid  will  be  formed  to  some  extent,  and  food  may  be 
taken  in  proportion. 

Its  Secretion  Favored  by  Cheerfulness.  — A cheerful  disposition, 
and  a happy,  lively  frame  of  mind,  are  highly  favorable  to  the  pro- 
duction of  the  gastric  juice ; while  melancholy  and  anger  and  grief 
and  intense  thought  of  business,  at  the  hour  of  meals,  greatly  hinder 
its  natural  flow. 

This  should  teach  us  to  go  to  our  meals  with  light  hearts,  and  to 
make  the  family  board  a place  of  cheerful  conversation,  and  of  a light 
and  joyous  play  upon  the  mirthful  feelings  of  all  present.  Should 
any  of  the  family  circle  be  in  the  habit  of  using  vinegar  as  a condi- 


HYGIENE. 


71 


merit,  we  should  never  be  guilty  of  compelling  them  to  extract  it 
from  our  faces.  A vinegar  face  is  not  easily  excused  anywhere ; at 
the  table  it  is  unpardonable.  A single  countenance  of  this  description 
will  throw  a gloom  over  a tableful  of  naturally  cheerful  persons  ; and 
if  habitually  present  at  the  board,  may  finally  spoil  the  digestion  of 
half  a dozen,  and  entail  dyspepsia  upon  them  for  life. 

The  stomachs  of  the  sick  pour  out  but  very  little  of  this  fluid,  and 
they  can  take  but  a small  amount  of  food.  It  is  cruel  to  deprive 
them  of  the  power  of  digesting  that  little  by  treating  them  harshly, 
and  filling  them  with  gloomy  and  desponding  feelings.  I therefore 
repeat  the  substance  of  the  advice  given  on  a previous  page : Deal 
gently  with  the  sick. 

How  all  this  is  Known.  — As  the  stomach  is  wholly  concealed 
from  view,  the  reader  will  very  naturally  ask  how  it  is  known  that 
the  gastric  juice  is  poured  into  it  in  certain  states  of  the  mind,  etc.,  and 
withheld  in  others.  It  certainly  could  not  have  been  so  accurately 
known,  had  it  not  been  for  an  accident  which  opened  the  living  and 
working  stomach  to  the  inspection  of  Dr.  Beaumont,  a United  States 
Surgeon.'  A young  man  by  the  name  of  Alexis  St.  Martin,  a Cana- 
dian by  birth,  but  then  in  the  State  of  Michigan,  had  a large  part  of 
his  side  torn  away,  and  a hole  of  considerable  size  made  into  his 
stomach,  by  the  accidental  discharge  of  a gun.  To  the  surprise  of 
his  surgeon,  St.  Martin  recovered ; and  the  edges  of  the  wound  in  the 
stomach  refused  to  grow  together,  preferring  rather  to  fasten  them- 
selves to  the  borders  of  the  breach  in  the  side,  thus  leaving  the  pas- 
sage open.  A kind  of  curtain  grew  down  over  this,  which  prevented 
the  food  from  falling  out.  Dr.  Beaumont,  taking  advantage  of  this 
state  of  things,  instituted  a series  of  valuable  experiments,  by  lifting 
the  curtain,  and  inserting  various  articles  of  food,  and  witnessing  the 
process  of  digestion. 

Movement  of  the  Stomach.  — The  presence  of  food  in  the  stom- 
ach causes  its  muscular  coat  to  contract  and  throw  it  about  from  side 
to  side,  mixing  it  thoroughly  with  the  gastric  juice,  and  reducing  it 
to  a pulpy  mass,  called  chyme.  This,  as  fast  as  it  is  properly  pre- 
pared, passes  through  the  pylorus  into  the  upper  bowel,  or  duodenum, 
called  also  the  second  stomach. 

Chyme.  — A certain  witty  professor  of  anatomy  and  physiology 
was  in  the  habit  of  asking  his  class  if  they  ever  saw  any  chyme ; and 
when  they  answered,  no,  as  they  often  did,  he  called  their  attention 
to  what  is  occasionally  to  be  seen  in  the  morning,  upon  the  sidewalks, 
where  drunken  men  have  held  themselves  up  by  lamp-posts,  and  left 
the  contents  of  their  stomachs. 

The  pylorus,  or  opening  into  the  bowel,  has  a very  singular  and 
wise  instinct,  which  is  worthy  of  remark.  When  a piece  of  food, 
which  has  not  been  digested,  attempts  to  pass  into  the  bowel,  the 
moment  it  touches  the  inner  surface  of  this  orifice,  it  is  instantly 


72 


HYGIENE. 


thrown  back  by  an  energetic  contraction ; though  a portion  of  well- 
prepared  chyme,  touching  the  same  opening  immediately  after,  is 
allowed  to  pass  unchallenged. 

Chyle.  — The  chyme,  when  it  reaches  the  duodenum,  seems  to 
cause  the  liver  to  secrete  bile,  and 
the  pancreas  to  produce  pancreatic 
juice.  These  two  fluids  are  con- 
veyed into  the  upper  portion  of  the 
second  stomach,  and  there  are  mixed 
with  the  chyme,  and  cause  it  to 
separate  into  a delicate,  white  fluid, 
called  chyle^  and  a residuum,  which, 
being  worthless,  is  pushed  onward, 
and  thrown  out  of  the  body. 

Bile  in  the  Stomach.  — Most 
persons  suppose  that  the  bile  is  gen- 
. erally  found  in  the  stomach ; but 
this  is  a mistake.  It  is  thrown  up 
by  vomiting,  because  in  that  act,  the 
action  both  of  the  first  and  the  second  stomach  is  reversed,  and  tin, 

bile  is  forced  up  from  the  duodenum 
— taking  a direction  the  opposite  ot 
its  usual  course. 

Destination  of  the  Chyle.  — Tht 

chyle  being  separated  from  the  dregs, 
is  pushed  onward  in  its  course  by  the 
worm-like  motion  of  the  intestine ; 
and  as  it  passes  along,  it  is  graduall7 
sucked  up  by  thousands  of  very  small 
vessels,  whose  mouths  open  upon  the 
inner  surface  of  the  bowel.  These 
little  vessels  are  called  lacteals,  from 
the  Latin  word  lac,  which  means  milk, 
because  they  drink  this  white,  milky 
fluid.  Fig.  61  shows  a section  of  the 
small  bowel,  turned  inside  out,  and 
covered  with  the  villi,  or  rootdike  fila- 
ments, closely  set  upon  its  surface,  for 
absorbing  the  chyle,  and  at  the  bottom 
of  which  the  lacteals  take  their  rise. 

In  these  lacteals,  and  in  the  mesen- 
teric glands,  the  chyle  is  gradually 
changed,  so  as  to  approach  nearer  and 
nearer  to  the  nature  of  the  blood  ; but 
precisely  what  the  change  is,  or  how 
it  is  effected,  is  not  known.  Several 


Fig.  61. 


HYGIENE. 


73 


learned  men  have  published  their  theories  upon  these  points,  and  the 
writer  has  opinions  upon  them ; but  it  is  not  worth  while  to  trouble 
the  reader  with  them.  It  is  sufficient  to  say  that  the  fluid  is  carried, 
by  the  lacteals  to  the  thoracic  duct,  through  which  it  is  conveyed  into 
a large  vein  at  the  lower  part  of  the  neck,  where  it  is  poured  into 
the  blood,  and  becomes,  after  going  through  the  lungs  and  experi- 
encing another  and  a vital  change,  the  material  out  of  which  our 
bodies  are  daily  and  hourly  new-created. 

Fig.  62  gives  a general  idea  of  the  stomach,  bowels,  etc. : 9,  being 
the  stomach ; 10,  10,  the  liver ; 1,  the  gall-bladder ; 2,  the  duct  which 
conveys  the  bile  to  4,  which  is  the  duodenum ; 3,  is  the  pancreas ; 5, 
the  oesophagus ; A,  the  duodenum ; B,  the  bowels ; C,  the  junction  of 
the  small  intestines  with  the  colon  ; D,  the  appendix  vermiformis ; 
E,  the  ccecum  ; F,  the  ascending  colon  ; G,  the  transverse  colon  ; H, 
the  descending  colon ; I,  the  sigmoid  flexure ; J,  the  rectum. 

Nature  and  Destination  of  Food. 

The  food  which  man  requires  for  his  support  and  development  is 
of  two  kinds,  inorganic  and  organic.  The  first  of  these  embraces 
certain  mineral  substances,  as  common  salt,  sulphur,  phosphorus, 
iron  and  lime,  either  in  combination  or  separate. 

These  are  not  generally  reckoned  as  aliments,  and  yet  no  human 
being  can  live  without  them.  In  their  absence,  the  body  decays,  dis- 
integrates, and  perishes.  Common  salt  is  composed  of  muriatic  acid 
and  soda.  The  first  is  an  important  ingredient  in  the  gastric  juice, 
and  the  latter  promotes  the  secretion  of  bile.  Sulphur  is  found  in 
several  of  the  tissues,  particularly  in  the  muscles.  Phosphorus, 
united  to  fatty  matter,  is  highly  honored  in  forming  a portion  of 
the  brain  and  nerves,  and  is  also  combined  with  oxygen  and  lime  to 
make  the  earthy  or  hard  part  of  bones. 

Found  in  Food.- — These  articles  it  is  not  necessary  often  to  intro- 
duce into  the  system  in  a separate  state.  They  are  contained,  in 
larger  or  smaller  proportions,  in  most  articles  of  food  ; and  man  al- 
ways suffers,  as  all  animals  do,  from  their  absence.  Common  salt  is 
found  in  the  flesh  of  animals,  in  milk,  and  in  eggs.  It  is  not  very 
abundant  in  plants ; and  we  all  know  how  eagerly  domestic  animals 
devour  it  when  it  is  given  to  them,  and  how  constantly  wild  cattle 
resort  to  the  salt  springs,  which,  in  the  great  W est,  are  called  “ buffalo 
licks.”  Lime  exists  in  nearly  all  animal  and  vegetable  substances. 
In  wheat  flour  we  get  it  in  combination  with  phosphoric  acid,  that 
is,  as  phosphate  of  lime.  Lime  exists  too,  in  the  state  of  carbonate 
and  sulphate,  in  all  hard  water.  Iron  is  found  in  the  yolk  of  eggs, 
in  .milk,  in  animal  flesh,  in  potatoes,  pears,  cabbages,  mustard  and 
other  articles.  Sulphur  we  get  in  flesh,  eggs  and  milk ; and,  as 
sulphate  of  lime,  in  spring  and  river  water.  Phosphorus  is  derived 
from  eggs  and  milk  ; and  flesh,  bread,  fruits,  and  husks  of  grain, 


V4 


HYGIENE. 


commonly  called  bran,  contain  even  a larger  proportion  than  we  need 
in  our  diet. 

Organic  Food.  — The  organic  elements  of  man’s  food,  which  in 
bulk  embrace  almost  the  whole  of  it,  remain  to  be  considered.  In  the 
animal  economy  they  serve  two  great  purposes.  A part  of  the  arti- 
cles which  compose  them  are  blood-formers,  out  of  which  all  the 
tissues  are  made,  — the  other  part  produces  fat,  which  serves  to  warm 
the  body  by  being  burned  with  oxygen.  These  articles  are  derived 
partly  from  the  vegetable  and  partly  from  the  animal  kingdom. 

Divided  into  Four  Groups. — For  convenience,  these  articles  may 
be  divided  into  four  groups.  For  the 
first,  sugar  stands  as  a type.  We  there- 
fore call  it  the  saccharine  group.  It  em- 
braces starch,  gum,  and  the  fibre  of  wood. 

These  articles  may  all  be  converted  into 
sugar  by  a simple  chemical  process. 

Figure  63  gives  a microscopic  view  of 
the  granules  of  starch. 

The  second  group  we  call  the  oleaginous. 

It  is  composed  of  oily  substances,  from 
whatever  source  derived,  whether  the  an- 
imal or  the  vegetable  world. 

The  third  group  is  the  albuminous.  A 
good  type  of  it  is  the  white  of  egg. 

T\\q  fourth  is  the  gelatinous.,  ox  jelly  group. 

First  and  Second  Groups,  Supporters  of  Respiration. — The  ar- 
ticles composing  the  first  and  second  groups  are  analogous  in  com- 
position, all  containing  oxygen,  hydrogen,  and  carbon.  They  are  what 
Liebig  calls  supporters  of  respiration ; the  meaning  of  which  is,  in 
more  comprehensible  terms,  that  they  are  supporters  of  combustion. 
They  are  the  fuel  which  warms  us.  They  keep  the  fires  going,  from 
which  arises  all  the  heat  we  have  in  our  bodies.  But  they  are  desti- 
tute of  nitrogen,  and,  on  this  account,  they  are  not  blood-formers,  and 
cannot  be  worked  into  flesh.  Hence,  man  cannot  live  on  them. 

The  food  articles  embraced  in  the  third  and  fourth  groups  also 
contain  oxygen,  hydrogen,  and  carbon ; and  to  these  they  add  nitro- 
gen. This  fourth  component  part,  which  forms  only  a small  portion 
of  them,  gives  them,  for  some  reason  never  explained,  the  peculiar 
quality  of  producing  blood  and  flesh.  They  are  the  raw  materials, 
out  of  which  our  bodies  are  reconstructed  from  day  to  day. 

Feed  a man  ever  so  largely  upon  sugar,  starch,  gum,  and  oils,  and 
he  wiU  starve  as  certainly  as  if  he  were  allowed  nothing  but  water. 

Names  of  Two  Great  Divisions  of  Food. — The  possession  or  non- 
possession  of  nitrogen,  then,  is  what  distinguishes  from  each  other 
the  two  great  classes  of  food-articles.  Those  which  contain  nitrogen 


HYGIENE. 


75 


haye  been  called  nitrogenized,  and  those  which  are  destitute  of  it, 
non-nitrogenized  compounds.  As  nitrogen  is  often  called  azote,  the 
former  class  are  more  frequently  named  azotized ; the  latter,  non- 
azotized. 

Let  the  reader  now  fix  it  in  his  mind  that  the  azotized  articles  of 
food  produce  blood  and  flesh ; the  non-azotized,  heat ; and  he  will 
have  the  key  to  understand  much  of  what  is  to  be  said,  and  likewise 
to  unlock  many  of  the  mysteries  of  diet. 


Nutrition  Table. — Taking  human  milk  as  the  standard,  and  ex- 
pressing the  amount  of  nitrogen  it  contains  by  100,  the  following 
table  shows  the  relative  amount  of  nitrogen  in  the  principal  flesh- 
producing  articles  of  food,  and  consequently  their  power  of  forming 
the  tissues : — 


Bic0 . 
Rye  . 
Corn 
Barley 
Oats . 
Wheat 


Human  Milk 
Cows’  Milk  . 
Oyster  . . . 

Yolk  of  Eggs 
Cheese  . . 
Eel  ...  . 
Pork-Ham  . 
Salmon  . . 


VEGETABLE. 


. 81  Potatoes 84 

. 106  Turnips 106 

. 125  Carrots 160 

. 125  Peas 239 

. 138  Beans 320 

. 144 

ANIMAL. 

. 100  White  of  Egg 845 

. 237  Herring 910 

. 305  Haddock 816 

. 305  Pigeon 756 

331-447  Lamb 833 

. 428  Mutton 852 

. 807  Veal 911 

. 610  Beef 942 


Other  Standards  of  Value. — We  must  not  infer  that  those  articles 
which  have  most  nitrogen  are  necessarily  best  adapted  for  human 
diet  because  they  are  the  most  effective  blood-producers.  In  deciding 
the  value  of  an  article  for  food,  other  things  are  to  be  looked  at  be- 
sides its  nutritive  qualities.  Those  which  are  poor  in  nitrogen,  are 
rich  in  carbon  and  hydrogen,  and  are  well  fitted  to  serve  the  double 
purpose  of  nourishing  and  warming  the  body  at  the  same  time.  The 
fitness  of  an  article  for  diet  depends  very  much  upon  the  ease  or 
difficulty  with  which  it  is  digested  and  assimilated.  If  an  article 
having  a great  deal  of  nitrogen,  and  being  very  nutritive,  is  with 
great  difficulty  reduced  in  the  stomach  by  the  digestive  process,  it 
may  be  much  less  desirable  for  food  than  one  which  is  digested  and 
assimilated  easily,  but  is  much  poorer  in  nutritive  qualities. 

Heat“generating  Food  Articles. ^ — The  reader  has  before  him  the 
principal  blood  and  tissue-forming  food  articles.  Those  which  we 
reckon  as  fuel,  or  heat-generators,  are  chiefly  oils,  sugar,  starch,  farina, 
sago,  arrowroot,  tapioca,  gums,  etc.  These  are  less  essential  than  the 
others ; for  the  blood-forming  articles  have  within  them  the  ele- 
ments out  of  which  fat  is  formed  in  the  process  of  assimilation ; for 


76 


HYGIENE. 


many  of  them  contain  starch ; and  this,  in  the  human  organism,  is 
changed  into  fat.  The  amount  of  starch  in  some  of  these  articles  is 
as  follows  : — 


Wheat  flour,  good  quality,  100,  contains  65  to  66  parts  in  100  pure  starch. 

Wheat  . . . . 

(( 

53  ‘ 

‘ 56 

(4  it 

Barley  meal  . . 

U 

64  ‘ 

‘ 65 

ti  a 

Barley  . . . . 

U 

37  ‘ 

‘ 37 

it  a 

it 

Rye 

a 

44 

‘ 47 

Buckwheat  . . 

...  108 

<i 

43  ‘ 

‘ 44 

u it 

it 

Indian  Corn  . . 

. . .138 

n 

65  ‘ 

‘ 66 

a a 

ti 

Bice 

n 

85  ‘ 

‘ 86 

a it 

it 

Peas 

it 

38  ‘ 

‘ 39 

it  a 

tt 

White  Beans  . . 

(( 

37  ‘ 

38 

it  ti 

it 

In  the  Nutritive  Food  Articles,  there  is  a fixed  relation  existing 
between  the  elements  of  the  tissue-formers  and  the  heat-producers 
which  they  contain.  Out  of  a few  of  them  Baron  Liebig  has  con- 
structed the  following  table  : — 


For  every  ten  parts  of  blood  and  tissue-formers  there  are,  — 


In  "Wheat  flour,  10 46  In  Barley,  10 67 

In  Rye  meal,  10 57  In  Rice,  10 123 

In  Oatmeal,  10 50  In  White  potatoes,  10 86 

In  Buckwheat,  10 130  In  Blue  potatoes,  10 130 


Diet  a Complex  Subject.  — From  the  facts  and  tables  now  pre- 
sented, it  appears  that  the  question  of  diet  is  one  of  complexity;  and 
that  the  determination  of  its  several  points  requires  that  a number  of 
things  should  be  taken  into  the  account.  First,  in  deciding  the  use- 
fulness of  any  article,  we  may  inquire  respecting  — 

Its  Digestibility. — If  an  article  be  not  digestible,  it  is  of  little 
consequence  how  much  or  how  little  albumen,  starch  or  nitrogen  it 
may  contain.  The  first  and  most  important  inquiry  respecting  it  is, 
is  it  digestible  ? If  not,  it  is  to  be  rejected ; for,  whatever  other  quali- 
ties it  may  have,  it  can  only  injure  the  stomach  and  embarrass  the 
whole  system. 

The  following  table  will  be  useful  to  the  reader,  though  I do  not 
set  it  down  as  reliable  in  all  cases.  There  is  often  a great  difference 
in  the  ease  with  which  different  stomachs  will  digest  the  same  food. 
Many  stomachs  are  afflicted  with  what  is  called  an  idiosyncrasy,  — a 
habit,  peculiar  to  itself,  of  rejecting  or  refusing  to  digest  some  one 
or  more  articles  which  are  acceptable  to  all  other  stomachs.  Tliis 
table  shows  the  length  of  time  required  for  digesting  the  several  ar- 
ticles in  the  stomach  of  St.  Martin,  as  shown  by  the  experiments  of 
Dr.  Beaumont;  — 


HYGIENE. 


77 


Articles. 

Preparations. 

Time. 

Articles. 

Preparations. 

Time. 

h.  m. 

h.  m. 

Eice 

Boiled 

1 — 

Pork,  recently  salted 

Raw 

3 — 

Pig’s  feet,  soused 

Boiled 

1 — 

Soup,  chicken 

Boiled 

3 — 

Tripe,  soused 

Boiled 

1 — 

Oysters,  fresh 

Roasted 

3 15 

Trout,  salmon,  fresh 

Boiled 

1 30 

Pork,  recently  salted 

Broiled 

3 15 

(i  ((  (( 

Fried 

1 30 

Pork  steak 

Broiled 

3 15 

Apples,  sweet,  mellow 

Raw 

1 30 

Corn  bread 

Baked 

3 16 

Venison,  steak 

Broiled 

1 36 

Mutton,  fresh 

Roasted 

3 15 

Sago 

Boiled 

1 45 

Carrot,  orange 

Boiled 

3 15 

Apples,  sour,  mellow 

Raw 

2 — 

Sausage,  fresh 

Broiled 

3 20 

Cabbage,  with  vinegar 

Raw 

2 — 

Beef,  fresh,  lean,  dry 

Roasted 

3 30 

Codfish,  cured,  dry 

Boiled 

2 — 

Bread,  wheat,  fresh 

Baked 

3 30 

Eggs,  fresh 

Raw 

2 — 

Butter 

Melted 

3 30 

liver,  beef’s  fresh 

Broiled 

2 — 

Cheese,  old,  strong 

Raw 

3 30 

Milk 

Boiled 

2 — 

Eg^s,  fresh 

Hard  boiled 

3 30 

Tapioca 

Boiled 

2 — 

Fried 

3 30 

Milk 

Raw 

2 15 

Flounder,  fresh 

Fried 

3 30 

Turkey,  wild 

((  (t 

Roasted 

2 18 

Oysters,  fresh 

Stewed 

3 30 

Boiled 

2 25 

Potatoes,  Irish 

Boiled 

3 30 

“ domesticated 

Roasted 

2 30 

Soup,  mutton 

Boiled 

3 30 

Potatoes,  Irish 

Baked 

2 30 

“ oyster 

Boiled 

3 30 

Parsnips 

Boiled 

2 30 

Turnip,  flat 

Boiled 

3 30 

Pig,  sucking 

Roasted 

2 30 

Beets 

Boiled 

3 45 

Meat  hashed  with  ) 

1 

Corn,  green,  and  beans 

Boiled 

3 46 

vegetables  ( 

Beef,  fresh,  lean 

Fried 

4 — 

Lamb,  fresh 

Broiled 

2 30 

Fowls,  domestic 

Boiled 

4 — 

Goose 

Roasted 

2 30 

<<  it 

Roasted 

4 — 

Cake,  sponge 

Baked 

2 30 

Veal,  fresh 

Broiled 

4 — 

Cabbage-head 

Raw 

2 30 

Soup,  beef,  vegeta-  I 

Beans,  pod 

Boiled 

2 30 

bles,  and  bread  j 

Custard 

Baked 

2 45 

Salmon,  salted 

Boiled 

4 — 

Chicken,  full-grown 

Fricasseed 

2 45 

Heart,  animal 

Fried 

4 — 

Apples,  sour,  hard 

Raw 

2 50 

Beef,  old,  hard,  salted 

Boiled 

4 15 

Oysters,  fresh 

Raw 

2 65 

Pork,  recently  salted 

Fried 

4 1.5 

Bass,  striped,  fresh 

Broiled 

3 — 

Cabbage,  with  vinegar 

Boiled 

4 30 

Beef,  fresh,  lean,  rare 

Roasted 

3 — 

Ducks,  wild 

Roasted 

4 30 

“ steak 

Broiled 

3 — 

Pork,  recently  salted 

Boiled 

4 30 

Corn  cake 

Baked 

3 — 

Suet,  mutton 

Boiled 

4 30 

Dumpling,  apple 

Boiled 

3 — 

Veal,  fresh 

Fried 

4 30 

Eggs,  fresh 

Boiled  soft 

3 — 

Pork,  fat  and  lean 

Roasted 

5 15 

Mutton,  fresh 

Broiled 

3 — 

Suet,  beef,  fresh 

Boiled 

5 30 

Boiled 

3 — 

Tendon 

Boiled 

5 30 

This  table  may  be  considered  as  giving  a general  idea  of  the  rela- 
tive digestibility  of  the  food-articles  contained  in  it.  If  not  found 
exactly  right  in  each  individual  case,  it  can  be  rectified  by  experience. 
The  experience  of  no  other  individual’s  stomach  will  ever  be  found 
precisely  like  that  of  St.  Martin’s,  — though  in  its  general  features, 
it  may  be  sufficiently  similar  to  make  his  valuable.  The  general 
principles  of  conduct  may  be  learned  from  the  experience  of  others. 
The  particular  application  must  come  from  our  own  experience  and 
reason. 

Digestibility  Influenced  by  Amount. — The  rapidity  with  which 
any  article  is  digested  will  vary  with  the  amount  taken.  A larger 
quantity  than  is  called  for  by  the  wants  of  the  system  will  be  di- 
gested more  slowly  than  the  proper  amount ; whale,  on  the  other 
hand,  an  insufficient  supply  begets  an  inability  to  reduce  in  the 
stomach  even  the  small  quantity  taken.  We  may  err  in  taking  too 


78 


HYGIENE. 


little  food  as  well  as  in  taking  too  much ; though  the  former  error  is 
much  less  likely  to  occur  than  the  latter. 

Choosing  Food  in  III  Health, — But  in  deciding  the  kind  and 
amount  of  food  we  must  be  guided  not  only  by  its  digestibility,  but 
by  the  state  of  the  health. 

If  we  find  the  stomach  apparently  in  good  working  condition,  capa- 
ble of  dissolving  properly  whatever  is  submitted  to  its  action,  and 
yet  we  are  for  some  cause  losing  flesh  and  strength,  we  should  resort 
not  only  to  the  most  nutritious  of  the  albuminous  group  of  the  azo- 
tized  articles,  but  likewise  to  the  oleaginous  group  of  the  non-azo- 
tized.  We  want  a great  amount  of  nutriment,  and  we  need  oils  to 
make  fat.  This  is  the  kind  of  food  generally  wanted  in  constitu- 
tional consumption. 

In  fevers,  but  little  food  can  be  disposed  of  at  best ; and  that  little 
must  be  chosen  with  reference  to  its  mildness  and  its  unstimulating 
qualities.  Generally  the  farinaceous  or  starchy  articles  are  most 
suitable,  because  they  have  no  stimnlating  and  irritating  qnalities, 
and  especially  because  they  furnish  fuel  to  be  burned  with  oxygen, 
and  thus  take  the  place  of  the  animal  tissues,  which  are  being  rapidly 
consumed  with  this  devouring  element.  In  fever,  oxygen  is  literally 
burning  up  the  body.  In  this  state  of  the  system,  this  element  ac- 
quires, by  some  means,  a singular  affinity  for  the  tissues ; and,  unit- 
ing with  them  rapidly,  forms  a true  combustion.  The  physician  who 
throws  to  this  devouring  agent  some  of  the  mild,  non-azotized  articles 
which  offer  it  stronger  affinities  than  it  finds  in  the  tissues,  is  as  wise 
as  he  who  tosses  his  dog  to  a hungry  lion  to  avoid  being  devoured 
himself. 

Exercise  to  be  Considered. — In  deciding  the  diet,  the  amount  of 
exercise  is  not  less  important  to  be  considered  than  the  health.  The 
farmer,  who  works  in  the  open  air,  and  uses  his  muscles  a great  deal, 
wants  considerably  more  nutritive,  as  well  as  more  combustive,  food 
than  one  who  leads  a sedentary  life.  Of  course  there  is  a great  deal 
more  waste  of  the  tissues,  and  he  requires  more  of  the  flesh-forming 
articles ; and  as  he  breathes  deeper,  and  takes  in  more  oxygen,  he 
needs  more  of  the  supporters  of  respiration,  — the  sugars,  oils,  and 
starchy  aliments. 

Beans. — By  turning  to  the  table  which  shows  the  amount  of  nitro- 
gen in  the  different  food-articles,  the  reader  will  see  that  beans  are 
rich  in  this  element.  They  are,  therefore,  excellent  food  for  working 
men,  who  are  obliged  to  make  great  use  of  their  muscles.  Our 
fathers,  who  broke  and  subdued  the  rocky  soil  of  New  England, 
showed  wisdom  even  in  their  instincts  in  taking  so  large  a portion 
of  their  aliment  from  the  bean,  — especially  as  they  oiled  it  with  the 
fat  of  pork.  But  for  the  hard-working  student^  who  daily  makes 
heavy  drafts  upon  his  brain  and  nervous  system,  beans  and  peas  are 
an  improper  diet.  They  contain  no  phosphorus^  in  the  shape  of 


HYGIENE. 


79 


phosphate  of  lime ; and  no  brain  can  work  hard  without  a due  supply 
of  phosphorus,  which  forms  a part  of  its  substance. 

Unbolted  Wheat  Flour, — For  the  man  who  uses  his  brain  a great 
deal,  there  is  no  other  one  article  of  food  equal  to  bread  made  from 
unbolted  wheat  flour.  Fine  wheat  flour  is  little  better  for  him  than 
beans,  because  the  miller  has  robbed  it  of  much  of  the  phosphorus, 
which  is  found  chiefly  in  the  hull  or  bran. 

I mention  only  two  or  three  articles  of  food  as  specimeiis.  By 
looking  over  the  tables  furnished,  and  reasoning  upon  the  whole  in 
the  way  I have  done  upon  these  few,  the  reader  can  give  every  arti- 
cle something  like  its  proper  value  in  most  circumstances. 

Climate. — If  health  and  exercise  should  influence  us  in  choosing 
the  kind  and  the  amount  of  food,  climate  must  do  so  quite  as  much. 

In  the  frigid  climate  of  high  latitudes,  it  is  necessary  that  a great 
deal  of  heat  be  produced  in  the  body,  in  order  to  avoid  perishing 
with  cold.  There  \s  no  mystery  now,  as  there  once  was,  about  the 
production  of  this  heat.  It  comes  from  the  burning  of  carbon  and 
other  substances  in  the  body,  where  they  unite  with  oxygen,  and 
make  just  as  real  a fire  as  that  which  warms  our  houses.  Oils,  sugar, 
starch,  gums,  etc.,  are  largely  composed  of  carbon,  and  readily  unite 
with  oxygen  in  the  body.  This  is  the  reason  they  are  reckoned  as 
fuel,  and  are  called  supporters  of  combustion.  And  for  this  reason, 
they  require  to  be  largely  consumed  in  very  cold  climates.  The  in- 
stincts of  men  seem  to  lead  to  the  same  conclusion,  for  the  dwellers 
in  all  high  latitudes  consume  great  quantities  of  oils  and  fats.  The 
amount  of  train-oil,  tallow,  the  fat  of  seals  and  other  animals,  devoured 
by  the  Laplanders,  Kamtschatkans,  and  other  northern  people,  is  truly 
wonderful. 

In  hot  countries,  the  fundamental  rule  for  preserving  the  health  is 
to  keep  the  body  cool.  Without  observing  this  rule,  the  strongest 
will  often  fall  victims  to  the  climate  in  low  latitudes.  But  to  keep 
cool,  of  course  all  the  heat-producing  articles  of  food  should  be 
avoided.  Particularly  all  alcoholic  drinks,  which  are  powerful  sup- 
porters of  combustion,  should  be  rejected.  Rice  and  the  various  fruits 
form  the  most  suitable  articles  of  diet. 

The  great  sacrifice  of  life  witnessed  among  the  early  emigrants  to 
California,  was  the  result  chiefly  of  using  ardent  spirits  and  heat- 
producing  food  while  crossing  the  Isthmus,  which,  to  a northern 
constitution,  is  much  like  a vast  oven,  heated  to  a temperature  suit- 
able for  baking  bread.  There  are  few  persons,  with  tolerable  health 
and  strength,  but  could  safely  endure  the  hottest  climate  if  they 
would  avoid  alcoholic  liquors  and  confine  themselves  to  an  abstem- 
ious vegetable  and  fruit  (Ret. 

Bayard  Taylor’s  Opinion. — The  distinguished  traveller,  Bayard 
Taylor,  reports  that  while  spending  a few  days  in  a heated  part  of 
Africa,  he  lived  as  the  inhabitants  did,  pretty  much  entirely  upon  the 


80 


HYGIENE. 


flesh  of  well-fatted  sheep  ; and  that  he  enjoyed,  meantime,  excellent 
health  and  strength.  From  this  he  concludes  that  animal  food  is  as 
suitable  in  hot  climates  as  in  cold. 

It  is  a pity  a man  of  such  excellent  parts  as  Mr.  Taylor  should 
have  allowed  himself  to  rear  so  tall  a structure  upon  so  narrow  a 
foundation.  That  he  could  live  on  flesh  in  so  hot  a region,  and  not 
be  made  sick,  only  proved  that  he  had  a fine  constitution,  and  that 
his  health  was  not  easily  disturbed ; and  when  he  attempted,  from 
his  limited  experience  of  a few  days,  to  reason  against  the  established 
facts  of  science,  and  against  the  well-attested  laws  of  life,  he  did  it 
evidently  without  reflecting  that  he  was  in  a field  of  thought  which 
he  never  had  occasion  to  cultivate. 

The  great  Jewish  Lawgiver  doubtless  had  a reason  for  prohibiting 
pork  to  the  Jews.  Whatever  that  reason  was,  the  prohibition  had  a 
wise  bearing  upon  the  health  of  the  people.  Palestine  has  a hot 
climate,  in  which  pork-fat  is  an  improper  diet. 

More  Fat  in  Winter, — It  follows  from  what  has  been  said,  that  a 
more  fatty  as  well  as  stimulating  diet  is  needed  in  winter  than  in 
summer.  But  the  change  should  be  made  gradually.  When  cold 
weather  approaches,  the  food  should  become  more  nutritious  and 
warming  by  little  and  little.  The  exercise  should  likewise  be  in- 
creased. 

Even  the  lower  animals  act  upon  this  plan.  In  the  fall,  squirrels 
eat  nuts,  which  are  full  of  oil,  and  grow  fat  upon  them. 

The  instincts  of  men  move  in  the  same  direction.  It  is  in  the  fall 
that  the  hog,  the  ox,  and  the  poultry  are  killed ; and  in  the  winter 
that  they  are  largely  feasted  upon  and  enjoyed.  Upon  such  food, 
combined  with  various  sorts  of  starch,  man  fattens  ; and  a good  sup- 
ply of  fat,  deposited  in  the  cells,  is  equal,  in  keeping  out  cold,  to  a 
layer  of  cotton  batting,  — to  say  nothing  of  the  fire  kept  up  within 
the  body  by  the  burning  of  such  fuel.  As  hot  weather  comes  on,  we 
gradually  lay  aside  these  fattening  articles  (or  ought  to),  and  return 
to  the  watery  vegetables  and  fruits,  such  as  squash,  string-beans, 
strawberries,  currants,  etc. 

Few  of  us,  I apprehend,  would  suffer  from  heat  in  summer,  if  we 
could  persuade  ourselves  to  abandon  stimulating  and  fire-producing 
food,  and  confine  ourselves  pretty  much  to  a cooling  and  succulent 
diet.  Diarrhoeas  in  summer  are  not  induced  by  eating  wholesome- 
vegetables,  but  by  combining  them  with  large  quantities  of  animal 
food. 

The  State  of  the  Mind. — This  should  by  no  means  be  over- 
looked in  choosing  the  kind  and  the  amount  of  food.  If  we  have 
lost  friends,  or  heard  desponding  news,  or  experienced  calamities  of 
any  kind,  we  must,  during  the  first  hours  of  the  shock,  or  even  during 
the  first  days,  if  the  affliction  be  heavy,  partake  very  sparingly  of  food. 
The  stomach  is  in  no  condition  to  receive  it.  The  brain  lies  pros- 


HYGIENE. 


81 


trate  under  the  stroke,  and  the  stomach,  in  sympathy  with  it,  asks 
for  a day  of  sorrow  and  fasting.  Disturb  it  not. 

Heat“producing  Food  Incompatible  with  Excitement. — It  is 

folly  to  take  heat-producing  aliment  when  laboring  for  days  under 
high  excitements.  During  political  campaigns,  when  the  blood  of 
politicians  is  at  the  boiling  point,  the  diet  should  be  unstimulating, 
— containing  very  little  animal  flesh,  and  not  much  combustive  food. 
Many  a man  has  died  of  apoplexy,  or  of  heart-disease,  by  putting  on 
the  steam  when  his  blood  was  up.  Whenever  we  have  a day  of  un- 
common excitement  to  pass  through,  we  should  always  begin  and 
end  it  with  an  unusual  degree  of  abstinence  as  to  the  amount  of  food 
taken,  and  with  special  care  that  the  articles  be  of  the  highest  kind. 

Anger  Demands  Abstinence. — Anger  is  a passion  which  espe- 
cially unflts  the  stomach  for  doing  much  work.  If  it  occur  often,  or 
be  protracted,  but  little  food  should  be  taken.  Those  who  indulge  it 
have  a double  cause  for  abstinence.  Both  their  folly  and  their  stom- 
achs call  for  a fast. 

Food  Adapted  to  Different  Periods  of  Life. — Food  must  vary  in 
different  periods  of  life.  The  infant  needs  a fattening  diet ; and  this 
has  been  supplied  in  the  milk  of  the  mother,  which  contains  more 
butter  (the  fattening  portion)  than  the  milk  of  any  other  animal. 
But  as  the  infant  has  much  less  exercise  than  the  young  of  animals, 
its  flesh  is  not  wasted,  and  it  does  not  require  so  much  azotized  food, 
that  is,  the  reader  will  remember,  food  with  nitrogen  in  it.  Accord- 
ingly, it  will  be  seen  by  looking  at  the  table  on  page  7 0,  that  human 
milk  has  much  less  of  this  element  than  that  of  the  cow.  As  the 
child  grows  up,  and  begins  to  take  active  exercise,  indoors  and  out, 
it  wants  more  solid  food,  and  teeth  make  their  appearance  to  masti- 
cate or  chew  it. 

In  Youth  and  Hanhood,  the  great  amount  of  exercise  usually 
taken  calls  for  larger  supplies  of  azotized  aliment,  — beef,  mutton, 
pork,  fowl,  fish,  wheat-flour,  corn-meal,  rye-meal,  potatoes,  turnips, 
peas,  beans,  etc.  This  is  the  working  part  of  life,  when  the  tissues 
are  rapidly  wasted  by  action,  and  the  flesh-forming  aliments  are 
wanted  to  keep  them  good. 

In  Old  Age,  the  exercise  is  diminished,  the  blood  circulates  more 
slowly,  and  the  body  grows  cold.  Now  is  the  time  to  resort  to  non- 
azotized  food,  — oils,  fats,  the  various  kinds  of  starch,  sugar,  and  the 
like.  These  will  furnish  fuel  to  warm  the  sluggish  blood,  and  will 
invest  the  body  with  fat,  which  will  serve  the  purpose  both  of  a cush- 
ion and  a garment.  Wine,  beer,  porter,  and  distilled  spirits  are  never 
needed  by  young  persons  in  health ; but  the  aged  are  frequently  bene- 
fited by  them,  if  taken  in  small  quantities.  They  are  chiefly  com- 
posed of  oxygen,  hydrogen  and  carbon,  and  are  properly  ranked  with 


82 


HYGIENE. 


the  supporters  of  combustion.  They  are  likewise  stimuiant,  and  add 
to  the  comfort  of  the  old  by  quickening  their  circulation.  Like  tea 
and  coffee,  they  diminish  the  waste  of  the  body,  and  thereby  lessen 
the  demand  for  food. 

The  smallest  amount  of  aliment  upon  wliich  a healthy  adult  person 
ever  lived  for  any  length  of  time,  was  twelve  ounces  a day.  Upon 
this  small  daily  allowance,  Lewis  Cornaro,  a noble  Venetian,  sub- 
sisted in  perfect  health,  during  the  protracted  period  of  fifty-eight 
years.  This  he  was  able  to  do  only  by  adding  daily  to  his  food 
about  twelve  ounces  of  light  wines.  I shall  have  occasion  to  refer 
to  tliis  case  again. 

Cost  of  Food. 

One  other  consideration  must  ever  influence  the  great  majority  of 
men  in  selecting  their  food.  I mean  its  cost.  It  is  a matter  of  great 
importance  to  the  poor,  to  know  what  kinds  of  food  they  can  subsist 
upon  with  least  expense.  Sometimes  provisions  are  so  high  that 
persons  in  poor  circumstances  greatly  need  advice  in  this  matter. 
Let  me  endeavor  to  furnish  some  information  which  shall  be  of  ser- 
vice to  the  reader. 


Milk  is  supplied  by  nature  to  be  our  first  food,  and  is  a good  type 
of  all  alimentary  substances.  It  contains 
curd,  which  has  nitrogen,  and  is  equivalent 
to  albumen  and  fibrin,  and  represents  the 
blood-formers.  It  has  butter  and  sugar. 

These  represent  the  heat-formers.  It  has 
salts,  which  contain  potash,  soda,  phospho- 
rus, etc.  Fig.  64  is  a microscopic  view  of 
good  milk ; Fig.  65,  of  poor  milk  ; and  Fig. 

66,  of  milk  adulterated  with  calf’s  brains. 

Food  will  be  valuable  in  proportion  as 
it  combines,  in  due  proportion,  the  articles 
contained  in  the  four  groups,  represented 
by  albumen,  fat,  sugar,  and  salts. 


Albuminous  Group. — Albumen,  fibrin,  casein,  and  gluten,  all  en- 
ter into  the  substance  of  animal  and  vegetable  bodies,  and  are  all 
composed  of  the  same  elements,  namely,  48  parts  carbon ; 36  of 
hydrogen ; 14  of  oxygen ; and  6 of  nitrogen.  In  containing  nitrogen 
they  all  differ  from  the  other  three  groups.  Albumen  being  a good 
type  of  them,  they  are  called  albuminous  compounds.  Albumen 
forms  a large  portion  of  the  serum,  or  colorless  part  of  the  blood. 
It  is  the  leading  principle  in  alimentation.  It  is  worked  up  into  the 
tissues  of  our  bodies.  It  forms  our  muscles,  our  membranes,  a por- 
tion of  our  nerves,  etc.  It  is  the  bricks  of  which  the  house  we  live 
in  is  made.  All  the  articles,  therefore,  which  are  chemically  consti- 
tuted like  it,  may  well  be  termed  albuminous. 


HYGIENE. 


83 


These  bodies,  consisting  of  the  four  organic  elements  named  above, 
have  been  called  quaternary  compounds.  Besides  these  elements,  they 
have  a minute  portion  of  sulphur  and  phosphorus.  They  are  also 
called  protein  or  proteinaceous  compounds. 

Albumen  is  a very  unstable  compound, — tending  strongly  to  de- 
composition. This  is  owing  to  the  complexity  of  its  composition, 


and  to  its  union  with  the  fickle  element,  nitrogen,  which  forms  chemi- 
cal compacts  reluctantly,  and  breaks  them  without  remorse.  Sub- 
stances which  coagulate  or  fix  albumen  in  an  insoluble  compound, 
or  preserve  the  tissues  of  the  body,  which  are  made  from  it,  from 
decomposition  or  putrefaction,  are  called  antiseptics. 

Fatty  Group. — The  next  group,  represented  by  fat,  performs  very 
important  offices  in  the  system,  — the  most  important  of  which  is  a 
union  with  albumen  in  the  formation  of  cells.  All  animal  and  vege- 
table life  begins  with  the  cell, — the  tiny  cup,  with  which  nature  dips 
all  the  streams  of  life  out  of  the  great  fountain  of  inorganic  matter. 
No  cell  is  formed  without  a minute  particle  of  oil.  The  portion  not 
used  in  forming  cells,  is  either  burned  as  fuel  to  keep  us  warm,  by 
uniting  with  oxygen,  or  it  is  stored  away  in  the  cellular  tissues,  add- 
ing to  the  hulk  of  the  person.  If,  then,  the  very  beginnings  of  life 
are  dependent  upon  fat,  it  is  of  great  importance  as  an  article  of  diet. 
So  necessary  is  it  in  the  economy  of  life,  that  when  not  taken  in  the 
food,  it  is  formed  out  of  albumen  in  the  processes  of  assimilation. 

The  Starch  and  Sugar  Group,  composed  of  several  kinds  of  sugar, 
gum,  etc.,  is  never  used  in  forming  the  tissues,  but  they  perform  im- 
portant offices  in  the  changes  going  on  within  the  human  organism. 
Thus,  sugar  of  milk  is  decomposed,  and  forms  lactic  acid,  so  called 
from  being  found  in  sour  milk.  This  acid  plays  a very  important 
part  in  the  process  of  nutrition. 

Pure  starch  is  a snow-white  powder,  having  a glistening  aspect. 
It  is  composed  of  grains  from  to  of  an  inch  in  diameter  in 
the  different  grains ; being  largest  in  the  potato  and  smallest  in 
wheat.  When  examined  with  the  microscope,  they  appear  as  in  Fig. 
63. 


84 


HYGIENE. 


The  Salts  Group  are  sufficiently  spoken  of  in  another  place. 

A wise  philosopher  in  ancient  time  said,  “ I do  not  live  to  eat  and 
drink ; I eat  and  drink  to  live.”  If  we  intend  to  eat  to  live,  we  must 
combine,  in  our  food,  the  four  groups  above  explained ; and  if  we 
would  live  at  as  small  expense  as  possible,  we  must  take  those  arti- 
cles which  are  low  in  price  and  rich  in  nutritive  matter.  The  fol- 
lowing table  will  help  the  reader  make  his  selections : — 


Table  of  the  relative  value  of  articles  of  food  arranged  according  to  their  proportions  of 
nutrient  matter  in  each  of  the  four  groups  of  elements  concerned  in  vital  changes. 


In  100  pounds  of 

Husk  or 
woody  fibre. 

1st  Group. 
Albuminous 
substances. 

2d  Group. 
Fats. 

3d  Group. 
Starch  and 
Sugar. 

4th  Group. 
Salts. 

Grains  : 

Wheat 

15 

15 

10  to  19 

2 to  4 

55 

2 

Barley 

15 

15 

12  to  15 

2 to  3 

60 

3 

Oats 

16 

20 

14  to  19 

5 to  7 

60 

4 

Bye 

12 

10  to  20 

10  to  15 

3 to  4 

60 

2 

Indian  Corn 

14 

6 

11 

8.1 

74 

li 

Buckwheat 

15 

25 

8 

0.4 

50 

4 

Bice 

13 

3 

7 

0.7 

79 

Oi 

Pod  Plants: 

Beans  

14 

Stoll 

24  to  28 

2 to  3 

40 

3 

Peas 

14 

9 

24 

2.1 

50 

3 

Boots  : 

Potato 

75 

4 

2.1 

0.3 

18 

1 to  li 

Turnip 

88 

2 

1.5 

0.3 

9 

1 to  425 

Carrot 

85 

3 

1.5 

0.4 

10 

li  to  2 

Beet  (mangold  wurzel) 

85 

2 

2 

11 

f to  1 

Long  red 

85 

3.03 

0.48 

10.36 

li 

Short  red 

85 

3.31 

0.26 

12.46 

.75 

Sugar  beet 

85 

2 

0.35 

13 

Parsnip 

80 

125 

2.5 

16 

i 

Leaf: 

Cabbage  

30  to  35 

Meal: 

Wheat  flour 

15 

10.8 

2 

70.5 

Byemeal 

15 

4.63 

8 

2 

73 

2 

Barleymeal 

15 

6.3 

2.4 

74 

2 

Oatmeal 

15 

12.6 

5.6 

64 

3 

Wheat  bran 

13.1 

55 

19.3 

4.7 

.6 

7.3 

The  following  tables  have  an  admirably  practical  bearing  upon 
economy  in  food  ; — 


100  lbs. 

Muscle- 
forming 
Elements, 
in  lbs. 

Fat-forming 
Elements, 
in  lbs. 

Relative  Propor- 
tion of  each, 
in  lbs. 

Husky,  or 
Woody  fibre, 
in  lbs. 

Barley 

14 

64 

Ito  4J 

15 

Beans 

26 

42 

1 to  l| 

10 

Beets 

2 

12 

1 to  6 

(?) 

Buckwheat 

8 

54 

1 to  6| 

25 

Carrots 

li 

10 

1 to  6| 

3 

Corn 

12 

77 

1 to  6j 

6 

Oats 

17 

66 

1 to  4 

20 

•Peas 

24 

52 

lto2i 

8 

Potatoes 

2 

19 

Ito  94 

4 

Turnms  (field) 

li 

9 

Ito  6 

2 

Do.  (Swedish) 

2| 

12 

1 to  54 

2 

Wheat  Flour 

11 

79 

1 to  7 

Wheat  Bran  

18 

6 

1 to  4 

55 

Cheese  (whole  milk) 

28.4 

51.1 

1 to  1| 

Cheese  (skim-milk) 

49.8 

6.3 

1 to  4 

HYGIENE. 


85 


Articles. 

Cost. 

Muscle-producing 

Elements. 

Cost  of  Moscle-pro- 
ducing  Elements. 

Barley  . . . : 

$1.00  per  bn. 

8.4  lbs. 

12c.  per  lb. 

Beans 

1.80  “ 

16.6  “ 

11c. 

i< 

Corn 

0.50  » 

6.7  “ 

7jc. 

U 

Oats 

0.35  “ 

5.2  “ 

7c. 

<i 

Peas 

1.00  “ 

14.3  “ 

7c. 

n 

Potatoes 

0.85  “ 

1.6  “ 

53c. 

Turnips 

0.50  “ 

1.2  “ 

41c. 

<< 

Flour  (fine) 

5.00  per  bbl. 

22.0  “ 

23c. 

u 

Flour  (unbolted) 

4.50  “ 

24.8  “ 

18c. 

(< 

These  tables  will  well  repay  study,  for  their  practical  use  will  save 
many  dollars  to  the  poor.  Let  it  be  remembered  that  producing 
muscle  is  the  same  thing  as  producing  strength,  or  labor-power. 
Bearing  this  in  mind,  the  following  table  will  be  very  interesting : — 


One  pound  of  labor-power  from  Potatoes  costs  53c.  per  lb. 


Fine  Flour, 

23c. 

Unbolted  do.,  18c. 

Turnips, 

41c. 

Barley, 

12c. 

Corn, 

7ic. 

Beans, 

11c. 

Peas, 

7c. 

Oats, 

7c. 

Meats  are  omitted  in  the  table.  So  far  as  their  nutritive  qualities 
are  concerned,  it  is  of  little  consequence  which  are  taken.  Some  are 
more  digestible  than  others,  and  this  consideration  should  influence 
those  with  weak  stomachs  in  selecting.  Every  person,  of  course, 
knows  their  relative  cheapness. 

Among  the  vegetables  given  in  the  table,  there  is  a wider  range 
for  choice.  Let  us  consider  them  in  course. 


Wheat. — In  this,  the  four  groups  are  represented  in  excellent 
proportion.  When  not  deprived  of  the  bran,  it  is  perhaps  the  very 
best  supporter  of  animal  life.  So  high  have  been  the  regards  of  men 
for  it,  and  so  generously  have  they  awarded  to  it  their  acknowledg- 
ments, that  its  product,  bread,  has  been  everywhere  called  “ the  staff 
of  life.”  The  settlement  and  cultivation  of  the  immense  prairies  of 
the  West  have  within  recent  years  so  increased  the  production  of 
wheat,  that  its  cost  is  now  less  than  half  what  it  was  fifty  years  ago, 
and  it  is  indeed  within  the  means  of  all  in  America. 

Barley. — This  has  the  four  groups  'represented  in  nearly  the  same 
proportions  as  wheat.  It  is,  therefore,  nearly  as  valuable  an  alimen- 
tary  grain.  Unfortunately  it  is  not  so  toothsome  as  wheat,  and  can 
never  be  so  popular  an  article  of  diet.  The  Scotch,  however,  feed 
upon  it  with  apparent  relish,  and  doubtless  think  it  strange  that  for- 
eign palates  are  not  better  pleased  with  it. 

Oats. — This  grain,  strange  to  say,  has  more  albuminous,  or  nutri- 
tive matter,  more  fat,  more  starch,  and  more  salts  than  wheat.  In 
uniting  a large  quantity  of  the  four  alimentary  groups,  it  surpasses 


86 


HYGIENE. 


every  other  vegetable  substance.  In  albumen,  it  is  not  quite  as  rich 
as  peas  and  beans,  and  in  starch  it  falls  a trifle  below  fine  wheat 
flour ; but  in  fat  it  is  exceeded  only  by  Indian  corn.  This  grain  is 
likewise  consumed  largely  by  the  Scotch, — a people  whose  claims  to 
shrewd  common  sense  are  well  supported  by,  as  their  hardy  constitu- 
tions vindicate,  the  choice.  This  grain  might  well  be  permitted  to 
take  the  place  of  rice.  It  affords  several  times  as  much  nutriment, 
while  it  costs  only  about  one-fifth  as  much.  There  is  good  reason 
why  the  horse  should  thrive  upon  oats.  Most  stable-keepers  think 
their  horses  will  do  more  work  upon  corn-meal,  but  this  must  be  a 
mistake.  In  using  oats  for  horse-feeding,  a large  portion  of  the  nu- 
triment is  lost  by  not  grinding  them. 

Rye. — This  is  also  a grain  of  considerable  nutritive  value.  It  is 
much  cheaper  than  wheat ; and  rye  meal  has  long  been  a standard 
article  of  diet  in  New  England,  — particularly  in  connection  with 
Indian  meal,  as  “brown  bread.”  It  is  useful  for  relieving  costive- 
ness,  in  the  form  of  “ hasty-pudding,”  with  molasses. 

Indian  Corn. — This  staple  article  of  American  produce  needs  no 
praise  from  me.  It  is  comparatively  cheap,  nutritive,  and  wholesome. 
It  abounds  in  fat  and  starch,  and  has  a fair  amount  of  albumen, 
though  not  as  much  as  the  oat,  the  barley,  or  the  wheat.  In  salts,  it 
is  rather  deficient.  Indian  corn  is  strictly  an  American  plant,  and  is 
perhaps  the  most  popular  grain  in  the  country.  It  has  emphatically 
a national  reputation,  and  is  perhaps  worked  up  into  more  savory 
dishes  than  any  other.  At  the  South  it  is  an  institution.  It  is  there 
made  into  hoe-cake,  corn-cake,  batter-cakes,  batter-bread,  muffins,  corn- 
pone,  etc.  At  the  North,  we  have  johnny-cake,  Indian  and  pumpkin- 
cake,  baked  Indian  pudding,  boiled  Indian  pudding,  beside  the  well- 
known  rye  and  Indian  bread,  and  other  preparations.  Give  an  in- 
genious Southern  or  Northern  housewife  a few  simple  adjuncts,  such 
as  lard,  milk,  sugar,  eggs,  cream  of  tartar,  and  soda,  and  she  will 
make  a pretty  respectable  larder  from  this  single  grain.  If  molasses 
be  substituted  for  sugar,  and  a little  stewed  pumpkin  be  thrown  in 
by  way  of  garniture,  we  may  have  several  preparations  which  are 
very  nourishing  as  well  as  cheap. 

Buckwheat. — Poor  in  nutritive  matter,  fat,  starch,  and  sugar,  but 
tolerably  well  supplied  with  salts.  It  will  do  very  well  for  batter- 
cakes  in  winter.  When  brought  smoking  upon  the  table,  and  served 
with  sugar  or  molasses  and  butter,  these  cakes  are  a luxury,  in  which 
the  rich  may  indulge  if  they  choose ; but  for  the  poor,  the  amount  of 
nourishment  they  afford  is  too  small  for  their  cost. 

Rice. — Much  like  buckwheat,  except  that  it  has  more  fat,  sugar, 
and  starch,  and  less  salts.  As  an  article  of  diet,  it  has  had  too  high 
a reputation.  Those  who  would  live  on  small  means  cannot  afford 
it.  Boiled  in  plain  water,  it  is  excellent  for  a relaxed  state  of  the 
bowels ; and  this  about  all  the  commendation  to  wliich  it  is  entitled. 


HYGIENE. 


87 


Beans.—  The  richest  in  nutritive  matter  of  all  vegetable  substances, 
except  cabbage  and  oats.  They  have  more  albumen  than  wheat,  or 
corn,  or  barley,  or  oats ; but  in  fat  and  starch  they  are  lower  in  the 
scale.  Add  to  them  salt  pork,  and  the  highest  of  all  nutrient  com- 
pounds is  obtained.  During  not  less  than  four  generations,  pork 
and  beans,  as  the  principal  diet,  nourished  an  iron-sided  race  of  men 
in  New  England.  Bean-porridge  was  like  honey  upon  the  tongue  of 
the  founders  of  New  England  institutions.  They  ate  it  morning, 
noon,  and  night ; and  thanked  God  for  it  every  time.  And  well  they 
might  thank  Him ; for,  with  Indian  corn,  it  furnished  them  with  a 
diet  better  adapted  to  their  condition  than  any  other. 

Peas. — Not  quite  as  rich  as  beans  in  albumen,  but  more  rich  in 
starch,  is  of  about  the  same  value  on  the  whole.  The  Canadian  French, 
in  Lower  Canada,  feed  on  peas  to  about  the  same  extent  that  the 
New  Englanders  did  on  beans.  Pea-soup,  as  prepared  by  the  best 
cooks  among  them,  is  a dish  of  great  nutritive  excellence ; and,  in 
my  judgment,  more  palatable  than  bean-soup. 

The  Potato. — Three-quarters  of  this  root  is  water,  and  it  is  poor 
in  all  the  elements  of  nutrition.  It  is  a palatable  article,  and  most 
persons  are  much  attached  to  it.  As  hulk  is  of  some  consequence  in 
food,  the  potato  is  not  without  value.  Men  do  not  often  live  entirely 
upon  potatoes, — not  even  in  Ireland.  Milk,  butter-milk,  and  espe- 
cially cabbage,  are  united  with  them. 

Turnips,  Carrots,  Beets,  Parsnips. — These  are  much  alike, — 
being  all  poor  in  nutritive  qualities.  They  serve  to  please  the  pal- 
ate by  furnishing  a variety  ; but  in  our  city  markets  they  are  expen- 
sive, and  do  not  furnish  an  economical  diet. 

Cabbage. — It  is  interesting  to  observe  how  the  instinets  of  men 
have  in  all  ages  led  them  to  select  those  articles  of  diet  which  their 
circumstances  have  demanded.  The  poverty  of  the  Irish  has  led 
them  to  subsist  largely  upon  the  potato,  — a root  which  the  soil  of 
their  country  yields  profusely.  But  as  this  root  has  but  little  nutri- 
tive matter,  necessity  required  that  it  should  be  united  with  some 
other  vegetable.  The  natural  instinct  selected  the  cabbage  ; and 
when  chemical  science  came,  at  length,  to  pass  judgment  upon  the 
correctness  of  this  instinct,  it  turns  out  that  the  cabbage  is  the  richest 
in  albumen  of  any  known  vegetable.  The  cabbage,  then,  is  the  nat- 
ural complement  of  the  potato  ; and  the  Irish  had  the  sagacity,  with- 
out science,  to  bring  the  two  together.  It  is  said  the  Irish  have  a dish 
named  “ kohl-cannon,”  consisting  of  boiled  and  mashed  potatoes  and 
cabbage,  seasoned  with  pork  fat,  pepper,  and  salt,  and  that  it  is  a 
truly  savory  dish.  It  certainly  is  a nourishing  and  a cheap  one.  The 
ambassador  who  was  sent  to  tamper  with  the  patriotism  of  a Roman 
who  had  dined  on  beans,  was  asked  if  he  was  silly  enough  to  think 
gold  and  silver  could  bribe  a man  who  was  satisfied  with  so  plain  a 


88 


HYGIENE. 


fare,  and  desired  no  other.  We  come  to  the  conclusion  then,  that 
bean-porridge,  pea-soup,  suet-pudding  sweetened  with  molasses,  oat> 
meal,  and  barley-bread,  with  “ kohl-cannon  ” for  those  who  can  digest 
it,  will  furnish,  for  hard-working  men,  the  most  substantial  diet,  at 
the  smallest  possible  expense.  To  render  these  dishes  savory,  and 
to  make  the  table  on  which  they  are  spread  an  inviting  board,  the 
deft  housewife  must  employ  her  best  skill  in  serving  them.  With 
the  thousand  “ fixings,  with  which  a New  England  matron  knows 
how  to  garnish  them  (or  would  know  how  if  they  came  within  her 
cuhnary  operations),  they  are  well  fitted  to  leave  savory  impressions 
upon  tongues  which  would  praise  them  to  the  end  of  life.  I speak 
of  these  articles  as  furnishing  a cheap  diet  for  working  men.  The 
indolent,  the  sedentary,  and  the  effeminate  from  various  causes,  could 
not  digest  them. 

The  Amount  of  Food  Taken. 

We  have  already  explained  that  this  should  be  governed,  in  part, 
by  the  amount  of  exercise  taken,  by  the  condition  of  the  health,  by 
the  state  of  the  mind,  by  the  climate,  by  the  season,  etc.  It  remains 
to  add  a few  words  in  a general  way,  respecting  the  absolute  amount 
required  by  an  adult  man. 

It  is  plain  enough  that  most  men  eat  too  much.  We  come  very 
near,  in  this  country,  being  a nation  of  gormands.  A principal  rea- 
son of  our  over-eating  is,  that  we  eat  so  fast.  When  the  food  is  well 
and  slowly  masticated  and  swallowed,  the  gastric  juice  has  time  to 
mix  with  it ; and  at  the  proper  moment  the  appetite  ceases.  But 
when  our  food  is  bolted  rapidly,  nature,  finding  her  laws  disregarded, 
and  all  her  purposes  frustrated,  stands  back,  and  lets  us  learn  to  stop, 
too  late,  alas ! from  a sense  of  fullness  in  a stretched  and  abused 
stomach. 

It  has  already  been  stated  that  Lewis  Cornaro  lived  fifty-eight 
years,  namely,  from  the  age  of  forty-two  to  one  hundred,  on  twelve 
ounces  of  solid  food  a day,  with  about  the  same  amount  of  light 
wines.  At  the  age  of  eighty-four  he  wrote  a book,  in  which  he 
praises  “divine  temperance”  in  terms  which  are  sometimes  eloquent 
and  often  enthusiastic.  Indeed  it  is  very  rare  that  a man  at  that 
age  retains  such  clearness  of  intellect,  and  especially  such  freshness 
of  feeling  as  he  evinces  in  his  book.  Probably  but  few  could  live  on 
the  amount  of  food  which  he  found  sufficient.  Yet  it  is  said  the 
distinguished  John  Wesley  lived  on  sixteen  ounces  a day,  which,  as 
he  took  no  wine,  and  had  to  derive  the  combustive  materials  for 
warming  the  body  from  the  food,  was  quite  as  scanty  a fare  as  that 
of  Cornaro.  Considering  that  he  led  a most  extraordinarily  active 
life,  both  of  body  and  mind,  being  half  his  waking  hours  in  the  sad- 
dle and  preaching  almost  daily,  this  is  probably  the  most  remarkable 
case  of  abstemiousness  on  record.  Jonathan  Edwards  did  not,  I 
think,  exceed  the  same  amount  of  food,  but  he  was  not  so  active  a 
man. 


HYGIENE. 


89 


Putting  aside  such  exceptional  cases  as  these,  we  may  say  in  round 
numbers,  that  a laboring  man  requires,  to  keep  him  in  health,  about 
two  or  two  and  a half  pounds  of  solid  food  per  day.  For  ministers, 
lawyers,  doctors,  authors,  and  merchants,  one  pound  and  a half  is 
amply  sufficient.  The  amount  should  be  increased  a little  by  a se- 
lection from  some  of  the  fuel-formers,  if  no  fermented  or  alcoholic 
drinks  be  taken,  and  slightly  diminished  if  they  are  used.  The  rea- 
son is  that  these  drinks  furnish  fuel  to  be  burned  in  breathing, 
which  has  to  be  drawn  from  the  food  when  they  are  not  employed. 
This  furnishes  no  motive  for  using  ardent  spirits ; for  there  is  fuel 
enough  to  be  had  in  the  oils,  starches,  and  sugars. 

Dyspeptics.  — It  is  said  that  dyspeptics  eat  more  than  persons  in 
health  ; and,  in  many  cases,  the  remark  may  be  true.  The  appetite 
of  a person  suffering  from  this  disease  is  almost  always  morbid,  and 
the  information  it  gives  respecting  the  real  wants  of  the  system  can 
seldom  be  trusted.  If  we  allow  a diseased  stomach  to  dictate  to  us 
when  and  what  and  how  much  we  shall  eat  and  drink,  our  misery 
for  life  is  a foregone  question.  A sick  stomach  is  like  a spoiled  child, 
— it  cries  for  what  it  should  not  have.  If  the  dyspeptic  will  live, 
and  enjoy  any  amount  of  peace  and  comfort,  he  must  follow  this 
simple  rule : To  eat  no  more  than  can  he  digested,  even  though  the 
amount  he  only  an  ounce  a day. 

Animal  and  Vegetable  Food. 

It  has  generally  been  supposed  that  it  was  intended  man  should 
subsist  on  a mixed  diet,  consisting  of  both  animal  and  vegetable 
substances.  Within  the  last  fifty  years,  however,  a school  of  physi- 
ologists have  appeared,  who  affirm  that  a vegetable  diet  is  alone 
consistent  with  the  laws  of  health.  They  declare  that  animal  food  is 
not  adapted  to  man’s  organization,  — that  it  unduly  stimulates  the 
blood,  predisposes  to  fevers,  consumptions,  diarrhoeas,  choleras,  apo- 
plexy, and  numerous  other  diseases,  and  of  course  shortens  life. 
That  such  a school  should  have  come  into  existence  in  this  country, 
where  animal  food  is  more  largely  consumed  than  in  any  other  part 
of  the  world,  in  proportion  to  the  number  of  people,  is  not  surprising. 
We  do,  undoubtedly,  eat  too  much  flesh.  So  enormous  is  the  consump- 
tion, that  notwithstanding  the  vast  herds  of  cattle  raised  in  all  our 
agricultural  states,  and  especially  on  the  western  plains,  the  demand 
keeps  up  with  the  supply  so  well  that  beef  brings,  on  an  average, 
about  twenty  cents  per  pound,  — at  least  twice  its  full  value  as  a 
blood-former. 

Facts  show  that  man  may  live  upon  flesh  alone,  upon  vegetables 
alone,  or  upon  flesh  and  vegetables  combined.  Is  it  best  he  should 
subsist  upon  vegetables  only,  or  upon  a mixed  diet?  A mere  affirm- 
ation upon  these  points  is  of  little  consequence.  To  cite  facts  avails 
nothing.  Men  have  a way  of  maldng  their  own  affirmations,  and  of 


90 


HYGIENE. 


looking  at  facts  with  eyes  wliich  sometimes  see  elearly  enough  on 
both  sides  of  them,  but  totally  ignore  their  existence. 

Man’s  Structure  Settles  the  Question. — To  settle  this  matter,  we 
must  appeal  to  man’s  organization.  His  structure  will  tell  us  some- 
thing we  need  not  mistake.  All  the  works  of  God  show  design. 
Everything  he  has  made  has  a use,  and  is  so  contrived  as  to  be 
adapted  to  that  use.  Lions,  tigers,  and  other  animals,  for  example, 
which  feed  on  flesh  alone,  have  a short  second  stomach,  — it  being 
only  about  three  times  the  length  of  the  animal’s  body.  Animals 
which  eat  no  flesh  have  a long  second  stomach,  — that  of  the  sheep 
being  from  thirty  to  thirty-five  times  the  length  of  its  body.  A very 
remarkable  difference  of  anatomical  structure! 

Tins  is  the  meaning  of  the  difference  : Vegetable  food  has  a great 
deal  of  waste  matter  in  it.  Woody  fibre  makes  quite  an  item  in  its 
composition.  This  waste  portion  must  be  carefully  separated  from 
the  nutritive  part,  and  this  must  all  be  done  in  the  second  stomach. 
It  takes  time  to  do  it.  It  must  not  be  done  in  a hurry.  The  nutri- 
tive materials  are  destined  to  build  a living  structure,  whose  dura- 
tion, like  that  of  all  other  fabrics,  will  depend  on  the  care  with 
which  the  materials  are  selected  and  put  together.  The  second 
stomach  of  the  sheep  is  long,  that  there  may  be  ample  time  for  the 
mixed  mass  of  chyme,  when  it  passes  out  of  the  first  stomach,  to  be 
changed  to  chyle,  and  then  to  be  carefully  separated  into  the  two 
parts,  the  useful  and  the  useless.  Animal  food  is  in  its  composition 
just  like  our  own  flesh,  — there  is  little  waste  matter,  and  not  much 
time  is  required  for  its  separation ; hence,  the  second  stomach  of 
flesh-eating  animals  is  short.  Nearly  the  whole  alimentary  mass  is 
quickly  taken  up  by  the  lacteals,  and  there  is  no  occasion  for  its 
travelling  through  a long  second  stomach. 

Man's  second  stomach  is  in  length  midway  between  that  of  the 
flesh-eating  and  the  vegetable-eating  animals.  If  there  be  design  in 
the  works  of  the  Creator,  and  if  that  design  in  the  structure  of  the 
flesh  and  vegetable-consuming  animals  has  now  been  correctly  inter- 
preted, it  is  plain  that  man  is  best  nourished  when  he  eats  both  kinds 
of  food.  The  structure  of  his  teeth  and  the  motions  of  his  jaws 
(see  p.  30),  confirm  the  same  conclusion. 

Americans  Eat  too  Much  Meat. — Yet,  as  I have  said,  there  is  no 
doubt  the  Americans  eat  too  much  meat.  Sedentary  persons  require 
but  very  little.  Less  is  wanted  in  summer  than  in  winter, — in  warm 
climates  than  in  cold.  People  of  wealth,  whose  circumstances  im- 
pose no  bodily  hardships,  need  less  than  the  poor,  who  are  much 
exposed,  and  work  hard;  whereas,  they  consume  more.  Those  who 
do  not  labor  with  their  hands,  should  never  taste  meat  more  than 
once  a day. 

It  is  painfully-amusing  (if  such  a compound  word  is  admissible) 
to  hear  a nervous  female,  whose  sole  exercise  consists  in  going  from 


HYGIENE. 


91 


the  parlor  to  the  kitchen  once  or  twice  a day,  and  in  making  a briei 
shopping  excursion  once  a week,  complain  that  she  cannot  maintain 
her  strength  unless  she  eats  freely  twice  a day  of  meat,  and  takes  her 
free  potations  of  strong  coffee  and  wine. 

A like  opinion  prevails  generally  among  the  feeble  who  are  not 
obliged  to  labor.  The  child  in  its  nurse’s  arms  must  daily,  it  is 
thought,  suck  a piece  of  chicken  or  beefsteak  in  order  to  thrive. 
Children  thus  fed  have  their  blood  constantly  inflamed,  and  stand  a 
poor  chance  when  attacked  by  scarlet  fever.  The  little  master  or 
miss  who  attends  school  complains  of  headache,  and  grows  pale, 
feeble,  and  nervous.  The  books  are  blamed  and  thrown  aside  for 
what  the  dishes  have  done.  The  doctor  is  called  in  and  assured 
that  the  dear  child  can  cat  nothing  but  a little  fat  broth,  a custard, 
or  cake ; and  if  he  presc  ibe  a diet  of  plain  bread  and  milk,  he  is 
believed  to  be  heartless,  r nd  his  prescription  is  not  followed. 

The  Majority  of  Mankind  Eat  no  Flesh.  — All  such  misguided 
persons  should  be  apprizec  that  the  great  majority  of  mankind  eat 
no  flesh,  because  they  cannot  afford  it.  And  they  do  not  appear  to 
suffer  from  its  loss.  Millions  of  Irish  do  not  taste  of  flesh  or  fish 
from  one  month’s  end  to  another.  Potatoes,  oatmeal,  and  cabbage 
constitute  their  chief  diet.  Rice,  poor  as  it  is  in  nourishment, 
sustains,  when  combined  with  vegetable  oil,  millions  of  people  in 
Asia.  The  Lazaroni  of  Naples,  with  active  and  finely  moulded 
forms,  live  on  bread  and  potatoes.  These  facts  do  not  afford  ground 
for  altogether  rejecting  animal  food,  any  more  than  Bayard  Taylor’s 
statement  respecting  whole  tribes  in  Africa  who  live  upon  flesh 
furnishes  a reason  for  excluding  vegetable  aliment.  Man  may  live 
and  enjoy  health  upon  either,  but  his  organization  implies  the  use 
of  both. 

Proportions  of  Animal  and  Vegetable  Food. 

Upon  this  subject,  it  is  impossible  to  fix  any  absolute  rules.  This 
is  a point  which  must  be  determined  by  the  temperament,  the  state 
of  the  health,  the  constitution,  etc.  Persons  of  a scrofulous  habit 
should  eat  freely  of  animal  food.  But  an  inflamed  stomach  should 
never  be  tormented  with  flesh.  Meat  is  stimulating,  and  will  be 
almost  sure  to  do  mischief  when  there  is  heat  and  tenderness  at  the 
pit  of  the  stomach.  There  are  cases  of  inflammation  of  this  organ, 
in  which  it  may  be  necessary  to  live  on  bread  and  milk,  with  articles 
of  the  starch  group,  for  months,  and  even  for  years. 

On  the  other  hand,  when  the  system  has  run  low  from  some 
exhausting  disease,  which  excites  no  feverish  action,  it  may  be 
necessary  at  times  to  take  a diet  almost  exclusively  animal. 

It  is  absurd  to  talk  of  the  same  diet  as  adapted  to  all  persons,  even 
when  in  health.  As  well  might  we  expect  one  shoe  to  fit  every 
foot,  or  one  coat  every  back,  or  one  color  every  eye,  or  one  doctrine 
every  mind. 


92 


HYGIENE. 


Temperance  the  Main  Thing.  — After  all,  the  great  thing  to  be 
aimed  at  is  temperance.  It  is  not  so  necessary  to  reject  one  article 
and  use  another,  as  to  partake  of  all  with  moderation,  “ I do  not 
live  to  eat  and  drink ; I eat  and  drink  to  live,”  said  a wise  philoso- 
pher of  the  olden  time.  One  would  think  the  moderns  have 
reversed  this  rule.  A modern  table  has  the  appearance  of  being 
spread  for  the  purpose  of  inducing  men  to  eat  all  their  stomachs  will 
hold.  A man  who  can  dine  daily,  for  half  a dozen  years,  at  one 
of  our  firskclass  hotels,  and  then  find  himself  free  of  dyspepsia  and 
all  other  diseases,  must  have  a fine  constitution,  as  well  as  most 
admirable  control  over  his  appetite.  Mr.  Addison  said,  “ When  I 
behold  a full  table  set  out  in  all  its  magnificence,  I fancy  I see 
gout,  cholic,  fevers,  and  lethargies  lying  in  ambuscade  among  the 
dishes  ” ; to  which  he  adds,  with  much  truth,  in  another  place, 
“ Abstinence  starves  a growing  distemper.” 

Good  Results  of  Temperance. — A temperate  diet  has  always 
been  attended  with  excellent  results,  and  always  will  be.  There  are 
times  of  great  anxiety,  when  abstinence  should  be  pushed  to  the 
extreme  verge  of  endurance.  During  the  siege  of  Gilbraltar,  Lord 
Heathfield,  its  gallant  defender,  lived  eight  days  on  four  ounces 
of  rice  per  day.  Dr.  Franklin,  when  a journeyman  printer,  lived 
two  weeks  on  bread  and  water,  at  the  rate  of  ten  pounds  of  bread  a 
week,  and  was  stout  and  hearty.  Dr.  Jackson,  an  eminent  physician 
in  the  British  army,  says,  “ I have  wandered  a good  deal  about  the 
world,  and  never  followed  any  prescribed  rule  in  anything;  my 
health  has  been  tried  in  all  ways ; and,  by  the  aid  of  temperance  and 
hard  work,  I have  worn  out  two  armies,  in  two  wars,  and  probably 
could  wear  out  another  before  my  period  of  old  age  arrives.” 

Lord  Bacon  was  right  in  the  opinion  that  intemperance  of  some 
kind  or  other  destroys  the  bulk  of  mankind,  and  that  life  may  be 
sustained  by  a very  scanty  portion  of  nourishment.  Cornaro,  whom 
I have  before  mentioned  as  having  lived  fifty-eight  years  on  twelve 
ounces  of  solid  food  a day,  wrote  as  follows  respecting  himself  in 
his  eighty-fifth  year : “ I now  enjoy  a vigorous  state  of  body  and 
of  mind.  I mount  my  horse  from  the  level  ground ; I climp  steep 
ascents  with  ease  ; and  have  written  a comedy  full  of  innocent  mirth 
and  raillery.  When  I return  home,  either  from  private  business  or 
from  the  senate,  I have  eleven  grand-children,  with  whose  education, 
amusement  and  songs  I am  greatly  delighted;  and  I frequently 
sing  with  them,  for  my  voice  is  clearer  and  stronger  now  than  ever 
it  was  in  my  youth.  In  short,  I am  in  all  respects  happy,  and  quite 
a stranger  to  the  doleful,  morose,  dying  life  of  lame,  deaf  and 
blind  old  age,  worn  out  with  intemperance.”  Howard,  the  philan- 
thropist, fasted  one  day  in  the  week ; and  Napoleon,  when  he  felt  his 
system  unstrung,  suspended  his  meals,  and  took  exercise  on  horse- 
back. 

Nothing  can  be  plainer  than  the  duty  of  fasting,  when  the 
stomach,  having  been  overworked,  is  disinclined  to  receive  food. 


HYGIENE. 


93 


Brutes  invariably  follow  this  suggestion  of  nature ; they  never  eat 
when  sick,  — probably  because  they  have  no  silly  nurses  to  coax 
them  to  swallow  stimulating  aliments.  The  habit  of  putting  high- 
seasoned  food  into  the  stomach  when  it  is  inflamed  and  feverish  is 
about  as  wise  as  directing  streams  of  blue,  violet,  or  red  light  into 
the  eye  when  it  is  red  and  swollen  with  inflammation. 

Tea  and  Coffee. 

It  is  proper,  before  closing  this  chapter  upon  diet,  that  something 
should  be  said  respecting  the  beverages  of  tea  and  coffee. 

Some  years  ago,  a meeting  was  held  by  the  leading  physicians 
of  a city  in  the  old  world,  in  which  the  merits  of  tea  and  coffee  were 
discussed.  In  this  discussion  each  man  first  stated  his  experience 
in  the  use  of  these  articles,  and  then  constructed  his  argument 
according  to  that  experience.  The  amount  of  what  the  reader  could 
learn  from  the  discussion  was  that  Dr.  A.  had  used  tea  all  his  life, 
and  been  benefited  by  it,  while  coffee  had  uniformly  injured  him ; and 
that  he  thought  tea  should  be  used,  while  coffee  should  be  rejected ; 
that  Dr.  B.  had  taken  coffee  at  breakfast,  and  found  it  an  excellent 
support  to  the  stomach  and  nervous  system,  while  tea  had  disturbed 
his  digestion  and  his  mind ; and  that  the  former  was  a beverage 
of  excellent  qualities,  while  the  latter  was  detestable ; that  Dr.  C. 
had  always  drank  both  tea  and  coffee,  and  recommended  them  to 
everybody ; and  that  Dr.  D.  had  himself  never  been  able  to  indulge 
either  tea  or  coffee,  and  would  have  them  both  expelled  from  every 
household.  ^ 

The  discussion  was  not  creditable  to  the  learned  and  really  able 
men  who  participated  in  it.  The  arguments  were  all  based  upon  the 
miserably  narrow  basis  of  single  individual  experiences.  They  were 
no  more  valid  than  that  of  the  man  who  should  hold  up  a shoe,  de- 
claring it  fitted  his  foot  the  best  of  any  he  ever  had,  and  recommend- 
ing all  men  to  have  their  shoes  made  upon  the  same  last. 

The  truth  is,  there  is  but  one  thing  which  can  be  affirmed  univer- 
sally of  the  effect  of  tea  and  coffee.  They  both,  when  taken,  tend  to 
prevent  waste  in  the  body,  and,  consequently,  less  food  is  required 
when  they  are  used.  This  may  be  affirmed  of  them  in  their  applica- 
bility to  all  persons,  but  nothing  further.  The  truth  is,  some  can 
drink  tea  but  not  coffee,  and  some  coffee  but  not  tea;  some  can  use 
both,  and  some  neither.  Every  man’s  susceptibility  to  the  effects  of 
these  beverages  is  his  own,  as  much  as  his  susceptibility  to  the  effects 
of  light,  or  heat,  or  atmospheric  changes;  and  these  effects,  each  per- 
son must  learn  from  experience.  Coffee  often  produces,  and  gener- 
ally aggravates,  a bilious  habit, — an  effect  which  cannot,  I believe, 
be  traced  to  the  use  of  tea.  I have  no  doubt  but  that  many  cases  of 
confirmed  dyspepsia  are  traceable  to  the  use  of  coffee  alone. 


94 


HYGIENE. 


Water. 

There  is  one  universal  beverage ; it  is  water.  All  men  are  fond 
of  it.  In  sickness  and  in  health,  in  joy  and  sorrow,  in  summer  and 
winter,  in  cold  climates  and  in  hot,  man  loves  and  drinks  water.  The 
stomach,  abused  and  made  sick  by  stimulating  food  and  drinks,  and 
repelling  everything  else,  still  gratefully  opens  itself  to  water.  Wher- 
ever man  exists,  therefore,  or  wherever  he  should  exist,  water  is 
found,  either  in  the  form  of  springs,  or  rnnning  brooks,  or  rivers,  or 
ponds,  or  lakes ; and  even  where  it  is  not  found  in  some  of  these 
forms,  it  is  periodically  dropped  down  from  the  clouds.  As  there  is 
no  element  in  nature  more  necessary  for  man’s  existence  than  water, 
so  there  is  none  more  universally  diffused. 

Pure  Water  Essential  to  Health. — But  water  varies  very  mate- 
rially, both  in  its  physical  qualities,  and  in  its  adaptation  to  its  pur- 
poses. Pure  water  is  as  essential  to  health  as  pure  air.  When  either 
of  these  fluids  is  rendered  impure  by  mixture  with  foreign  matters, 
disease  will  be  a frequent  result.  The  ancients  must  have  been  in- 
fluenced by  this  fact,  or  they  would  not  have  incurred  such  heavy 
expenses  in  procuring  pure  water  from  great  distances.  The  strong 
aqueducts  through  which,  for  many  miles,  large  streams  of  water  are 
even  at  this  day  poured  into  Rome,  attest  the  freeness  of  the  expendi- 
tures she  made  for  this  purpose  in  the  day  of  her  greatest  renown. 
We  may  pity  the  ancient  Romans  for  being  governed  in  their  military 
operations  by  tbe  opinions  of  augurs  and  soothsayers,  and  certainly 
these  things  were  silly  enough ; but  in  other  things,  at  first  view 
equally  superstitious,  they  showed  practical  wisdom.  Vetruvius  re- 
ports that  in  selecting  the  sites  of  their  cities,  they  inspected  the 
livers  and  spleens  of  animals  to  learn  the  salubrity  of  the  waters  and 
the  alimentary  productions  of  the  region.  The  size  and  condition  of 
these  organs  do  in  fact  indicate  the  nature  of  the  pasturage  and  the 
qualities  of  the  water  with  which  animals  are  supplied.  No  people 
can  enjoy  good  health  when  subjected  to  the  double  influence  of  bad 
water  and  impure  air. 

Division  of  Water. — The  simplest  division  of  water  is  into  two 
kinds,  soft  and  hard.  Rain,  river,  pond,  and  snow  water  is  soft: 
well  and  spring  water  is  generally  hard.  Soft  water  contains  but 
little  impurities,  and  when  used  for  washing,  forms  a good  lather 
with  soap.  Hard  water  contains  at  least  one  of  the  salts  of  lime, 
often  more ; mixed  with  soap,  it  curdles  and  turns  white.  The  reason 
of  this  is,  that  the  oily  acids  of  the  soap  unite  with  the  lime,  and 
form  a compound  which  the  water  will  not  dissolve.  Such  water  is 
not  suitable  for  domestic  purposes. 

Chemical  Nature  of  Water. — Water  contains,  reckoning  the  ele- 
ments of  which  it  is  composed  in  volumes,  two  volumes  of  hydrogen, 
and  one  volume  of  oxygen.  These  two  gases,  the  unlearned  reader 


HYG1EN15. 


95 


will  please  remember,  are  highly  subtle  bodies,  not  visible  to  the  eye ; 
and  yet,  when  chemically  united,  they  form  a liquid  which  covers 
two-thirds  the  entire  surface  of  the  globe,  — floating  upon  its  bosom 
the  navies  and  merchant  ships  of  all  nations,  and  by  ite  unmeasured 
depths  and  vast  breadths  and  sublime  movements,  fills  the  thoughtful 
mind  with  conceptions  of  creative  Power,  which  words  never  attempt 
to  express.  Should  the  two  gases  which  compose  this  vast  body  of 
water  cease  to  love  each  other,  and  fall  asunder,  the  first  lighted  taper 
would  set  the  world  on  fire,  and  not  a living  being  upon  its  surface 
could  escape  destruction. 

Impurities  in  Water. — It  is  not  surprising  that  a fluid  with  as 
great  a solvent  power  as  water,  should  often  dissolve  and  hold  in 
solution  a great  many  impurities.  In  passing  along  through  the 
earth,  before  it  comes  up  in  springs  and  wells,  it  is  filtered  through 
various  mineral  earths,  and  becomes  contaminated  accordingly.  In 
running  through  beds  of  limestone,  it  takes  up  a little  carbonate  of 
lime.  Salt-beds  impart  to  it  common  salt  (muriate  of  soda),  while 
sulphur  and  other  ores  tinge  it  with  salts  of  various  kinds. 

Water=SuppIy. — At  the  present  time  all  large  cities  and  most  of 
the  towns  in  this  country  are  supplied  with  water  for  domestic  pur- 
poses, either  from  ponds  or  lakes,  or  from  artesian  wells,  of  greater 
or  less  purity,  but  in  almost  all  cases  superior  to  the  common  welh 
water,  so  liable  to  contamination  by  cesspools  and  sewage.  The  re- 
sult is  that  the  health  of  the  people  has  been  materially  improved, 
and  fevers,  particularly  those  of  a typhoid  type,  have  diminished  both 
in  prevalence  and  fatality.  The  decaying  vegetable  and  animal  mat- 
ter, which  formerly  was  washed  into  the  soil,  and  percolated  into  and 
poisoned  the  wells,  is  now  washed  away  by  copious  supplies  of  pure, 
fresh  water. 

Lead  Pipes. — In  cities,  water  is  usually  conveyed  through  the 
dwellings  in  leaden  pipes,  — a practice  fraught  with  a danger,  to 
avoid  which  various  expedients  have  been  devised.  That  lead  does 
often  become  oxidized  and  impart  its  poisonous  properties  to  water 
when  long  in  contact  with  it,  is  a well-known  fact.  Let  a number  of 
persons  drink  every  morning  from  the  the  first  water  drawn  from  the 
pipes,  and  a portion  of  them  will  be  attacked  with  some  form  of  lead 
disease.  The  pipes  should  be  emptied  every  morning  before  using 
the  water  for  domestic  purposes,  and  then  there  is  little  danger.  Tin- 
lined  pipes  have  been  found  to  be  almost  entirely  free  from  danger 
of  lead-poisoning. 

Physical  and  Other  Properties  of  Water. — Good  water  is  with- 
out smell,  is  perfectly  clear,  and  in  the  mouth  has  a soft  and  lively 
feel.  When  poured  from  one  vessel  to  another,  it  should  give  out 
air-bubbles.  Boiled  and  distilled  waters  have  a vapid,  flat  taste. 
This  is  owing  to  their  containing  no  carbonic  acid  gas  or  atmospheric 


96  HYGIENE. 

air, — these  being  driven  off  in  the  act  of  boiling  and  distilling.  A 
hundred  cubic  inches  of  good  river  water  contain  about  2^  of  carbonic 
acid,  and  of  common  air. 

Carbonic  acid  is  what  gives  to  mineral,  or  soda  water,  its  brisk, 
and  even  pungent  taste.  Without  a portion  of  tliis  acid  and  atmos- 
pheric air,  water  is  perfectly  insipid,  and  not  fit  to  be  used  as  a bev- 
erage. Hence,  if  it  be  boiled  or  distilled  to  clear  it  of  earthy  matters, 
we  must  expose  a large  surface  of  it  to  the  air,  and  shake  it,  that  'it 
may  re-absorb  from  the  atmosphere  what  it  has  lost,  and  thus  recover 
its  taste. 

Rain  Water  is  the  Result  of  Distillation  on  a large  scale,  and 
would  be  insipid,  like  other  distilled  water,  only  that,  after  being 
distilled  off  from  the  waters  upon  the  surface  of  the  earth,  it  recovers, 
while  ascending  as  vapor,  the  carbonic  acid  and  atmospheric  air. 

Fishes  breathe  air  as  well  as  land-animals,  and  hence,  lakes  upon 
the  tops  of  high  mountains,  where  but  little  oxygen  can  be  absorbed 
into  the  water  from  the  air,  are  not  inhabited  by  the  finny  tribes. 

The  Saltness  of  the  Ocean  is  simply  the  accumulation  of  the  saline 
substances  washed  out  of  the  bowels  of  the  earth. 

The  water  which  for  thousands  of  years  has  been  distilling  off  as 
vapor  from  the  surface  of  the  ocean  is  nearly  pure.  Being  carried 
by  the  winds  to  tlie  continents,  it  falls  as  rain,  sinks  into  the  earth, 
is  filtered  through  mineral  substances,  comes  to  the  surfaces  in  springs, 
is  collected  into  rivers,  and,  with  all  its  freight  of  mineral  salts,  is 
borne  back  to  the  ocean.  Everything  that  water  can  dissolve,  and 
carry  down  from  the  continents,  finds  a great  depository  in  the  ocean ; 
and  as  this  has  no  outlet,  the  accumulation  must  go  on  without  limit. 
Rivers  which  flow  into  the  ocean  contain  from  ten  to  fifty  grains  of 
salts  to  the  gallon, — composed  chiefly  of  common  salt,  sulphate  and 
carbonate  of  lime,  magnesia,  soda,  potash  and  iron ; and  these  are 
the  constituents  of  sea-water. 

Cleansing  of  Impure  Water. — Impure  waters  should  be  cleansed 
before  being  used  for  domestic  purposes.  Distillation  is  tbe  most 
perfect  method  of  purification.  Filtration  through  sand  is  a good 
method.  It  removes  all  suspended  vegetable  or  animal  matter,  and 
all  living  animals.  Boiling  likewise  kills  all  animals,  and  throws  to 
the  bottom  carbonate  of  lime.  It  is  this  which  constitutes  the  crust 
which  lines  tea-kettles  in  all  regions  where  limestone  exists. 

Settlers  in  a new  country  should  make  it  a prime  object  to  find 
good  water.  This  is  of  great  moment.  Their  own  health  and  the 
health  of  their  posterity  is  dependent  upon  it.  Any  soil,  good  or 
bad,  is  not  worth  half  price,  if  it  yield  impure  water. 

Reasons  for  Prizing  Water. — Finally,  we  ought  all  to  prize  water 
very  highly,  for  it  composes  nearly  eight-tenths  of  our  entire  bodies^  in- 
cluding our  flesh,  blood,  and  other  fluids.  Nay,  we  owe  to  it  the  very 


HYGIENE. 


97 


softness,  delicacy,  and  smoothness  of  our  persons.  Our  muscles, 
nerves,  blood-vessels,  glands,  cartilages,  etc.,  all  play  smoothly  upon 
each  other  in  consequence  of  water.  Take  all  the  water  out  of  us, 
and  we  should  be  dry  sticks  indeed.  All  our  comeliness  would  be 
gone.  Nobody  would  or  could  love  us.  We  should  be  walking 
reeds,  shaken  and  sported  with  by  every  wind.  Let  us  never  forget 
how  much  we  are  indebted  to  water. 

Exercise. 

Animal  life  is  conditioned  upon  exercise.  Without  it  health  can- 
not exist,  or  life  itself  be  continued  for  any  great  length  of  time. 

Proper  exercise  communicates  motion  to  every  part  susceptible  of 
it.  It  expands  the  chest,  contracts  and  relaxes  the  muscles,  quickens 
the  motion  of  the  blood,  moves  afresh  all  the  other  fluids,  and  stirs  to 
the  centre  of  the  whole  frame.  More  easy  and  perfect  digestion,  the 
nutrition  of  every  part,  and  the  proper  performance  of  all  the  secre- 
tions and  excretions,  are  the  results  of  such  exercise. 

A distinguished  physician  said : “ I know  not  which  is  most  neces- 
sary to  the  support  of  the  human  frame,  food  or  motion.”  Some  of 
the  finest  talents  in  the  world  are  probably  lost  for  the  want  of 
exercise ; for  without  it  the  mind  loses  its  keen  perception  and  its 
bounding  energy,  its  power  of  application  and  its  general  scope.  If 
men  of  great  talents  would  give  attention  to  exercise,  the  world 
would  reap  a larger  harvest  from  their  written  thoughts. 

The  arrangements  of  modern  society  have  very  much  abridged  the 
facilities  for  taking  exercise ; but  if  Trenck  in  his  damp  prison, 
with  fetters  of  seventy  pounds  weight  upon  him,  could  preserve  his 
health  by  leaping  about  like  a lion,  most  persons  could  do  as  much 
with  the  fetters  of  modern  society  upon  their  limbs. 

Must  be  Regular. — Exercise,  to  be  of  much  service,  must  be  regu- 
lar, — not  taken  by  fits  and  starts,  — a good  deal  to-day  and  none  to- 
morrow ; but  in  reasonable  measure  every  day.  Occasional  efforts, 
with  intervening  inactivity,  only  does  mischief. 

Must  be  Pleasurable It  should  be  connected,  too,  if  possible, 

with  some  pleasing  occupation  or  pursuit.  The  movement  of  the 
limbs  should  carry  us  towards  some  place  or  end  in  which  the  mind 
feels  an  interest ; exercise  will  then  do  us  most  good.  Hence  botan- 
ical pursuits,  the  cultivation  of  a garden,  and  the  like,  are  often  pre- 
ferable to  a solitary  and  aimless  walk. 

Must  not  be  Excessive. — Exereise  should  never  be  carried  so  far 
as  to  produce  great  fatigue.  Extremes  are  injurious ; and  too  much 
exercise,  especially  by  a sick  or  feeble  person,  may  be  as  injurious  as 
too  little. 

No  clothing  should  be  thrown  off  after  exercise,  nor  should  one 
cool  oft’  by  sitting  in  a draft  of  air.  Very  serious  consequences  often 
follow  this  practice. 


HYGIENE. 


9? 


Not  to  be  Taken  After  Meals. — It  is  not  best  to  take  exercise  im- 
mediately after  meals.  The  reasons  for  this  caution  have  been  ex- 
plained. It  is  true  many  laboring  men  go  at  once  to  their  work  after 
eating,  without  apparent  injury.  Yet  they  are  strong,  and  can  en- 
dure what  those  who  use  their  brains  chiefly  could  not.  And  even 
they  do  not  labor  as  easily  and  cheerfully  immediately  after  dinner. 

Active  and  Passive. — Exercise  is  properly  divided  into  active  and 
passive.  Walking,  running,  leaping,  dancing,  gardening,  various 
sports,  etc.,  are  active.  While  sailing,  swinging,  and  riding  in  car- 
riages are  passive.  Riding  on  horse-back  is  of  a mixed  nature, — 
being  both  active  and  passive. 

A few  remarks  upon  these  several  kinds  of  exercise  will  have  a 
practical  value  to  some  of  the  readers  of  these  pages. 

Walking  is  one  of  the  most  gentle,  easy,  and  generally  one  of  the 
most  useful  of  the  active  exercises.  It  is  within  the  reach  of  all  who 
have  the  use  of  their  limbs,  and  is  indulged  at  the  expense  only  of  a 
little  shoe-leather.  To  make  it  agreeable,  the  face  is  only  to  be 
turned  to  some  favorite  locality,  and  the  mind  put  in  communion 
with  the  voices  of  nature. 

To  walk  with  the  best  advantage,  the  body  should  be  kept  upright, 
the  shoulders  thrown  back,  the  breast  projected  a little  forward,  so  as 
to  give  the  lungs  full  play,  and  the  air  an  opportunity  to  descend  to 
the  bottom  of  them.  This  attitude  places  all  the  organs  of  the  body 
in  the  most  natural  position,  and  relieves  them  from  all  restraint. 
Walking  then  becomes  a source  of  pleasure.  The  artist  who  bends 
over  his  pallet,  and  gets  into  a cramped  position,  is  by  this  kind  of 
walking  relieved,  and  his  body  kept  upright.  Females,  particularly 
of  the  wealthier  class,  are  much  more  apt  to  neglect  this  species  of 
exercise  than  males. 

It  is  not  so  in  England.  There  it  is  no  uncommon  thing  for  ladies 
of  high  rank  to  walk  ten  miles  a day ; and  they  do  it  in  shoes  of  suf- 
ficient thickness  to  protect  their  feet  from  all  dampness,  and  in 
clothes  large  enough  to  give  their  muscles  full  play.  As  a conse- 
quence, they  enjoy  excellent  health,  and  in  many  cases  even  retain 
their  freshness  and  beauty  to  old  age. 

A master  of  one  of  the  vessels  of  our  navy  who  spent  some  time, 
lately,  in  the  British  Channel,  was  several  times  invited  to  spend  the 
evening  at  Lord  Hardwick’s,  where  he  made  the  acquaintance  of  two 
daughters  of  his  lordship,  who,  in  the  drawing-room,  he  thought  the 
most  accomplished  ladies  he  ever  saw.  Yet  those  young  women,  on 
two  occasions,  in  company  with  other  friends,  walked  miles  to  visit 
his  vessel,  once  on  a rainy  day,  clad  in  thick,  coarse  cloth  cloaks  which 
no  rain  could  penetrate,  and  caring  as  little  for  wet  weather  as  a 
couple  of  duckso 

Good  for  the  Studious. — For  the  studious,  walking  is  a most  capi- 
tal exercise.  It  varies  the  scenes  so  constantly,  and  brings  the  mind 


HYGIENE. 


99 


m contact  with  so  many  objects,  that  the  monotony  of  in-door  life  is 
admirably  broken.  It  was  a maxim  of  Plato,  that  “ he  is  truly  a crip- 
ple, who,  cultivating  his  mind  alone,  suffers  his  body  to  languish.” 

Good  in  Cold  Weather. — Walking  is  valuable  in  cold  weather, 
because  it  exposes  one  to  the  cold  atmosphere,  and  hardens  the  person 
against  frosty  weather,  — a consideration  of  great  consequence  in 
countries  which  are  subject  to  extremes  of  cold. 

Running  and  Leaping  are  forms  of  exercise  which  should  be  in- 
dulged with  prudence  even  by  the  young  and  healthy.  For  the  feeble 
and  the  aged,  they  are  entirely  inadmissible.  Used  cautiously,  in  a 
system  of  regular  training,  they  may  help  raise  the  bodily  powers  to 
a high  degree  of  agility  and  endurance.  The  North  American  Indian, 
who  was  bred  to  the  chase,  ran  with  surprising  swiftness,  and  for  en- 
durance was  scarcely  excelled  by  his  faithful  dog.  What  training 
has  done  for  the  Indian,  it  may  do  for  the  white  man,  who  may 
chance  to  inherit  as  good  a constitution. 

The  Game  of  Base°BalI  requires  very  active  running,  and  for  the 
young,  it  is  an  exceedingly  healthful  amusement.  It  fills  the  whole 
frame  with  a bounding  spirit,  and  sets  the  currents  of  life  running 
like  swollen  brooks  after  heavy  rains. 

Gymnastics. — The  more  active  species  of  exercise  have  generally 
been  included  under  the  term  gymnastics.  Among  the  Greeks  and 
Romans,  feats  of  strength  and  endurance  were  supposed  to  confer 
honor.  For  this  reason,  and  because  war  was  a laborious  calling,  re- 
quiring bodily  endurance  and  strength,  their  youth  were  trained  in 
the  most  active  exercises.  Gymnastic  games  were  with  them  at  once 
the  school  of  health  and  the  military  academy. 

In  England,  during  the  middle  ages,  acts  of  Parliament  and  royal 
proclamations  were  employed  to  regulate  and  foster  those  manly 
sports  and  exercises,  which  fitted  the  people  for  the  activity  required 
on  the  field  of  battle. 

Those  preparations  for  brutal  wars  would  be  unsuited  to  the  pres 
ent  state  of  the  world ; but  the  capacity  for  endurance  which  these 
trainings  produced,  could  be  most  usefully  employed  in  the  laborious 
and  scientific  researches  which  modern  advancement  requires.  Very 
lew  of  our  scientific  men  have  sufficient  hardness  of  frame  to  sustain 
them  in  their  laborious  studies. 

The  heart-diseases  which  prevail  so  extensively  are  the  result, 
many  of  them,  of  violent  exercise,  taken,  perhaps,  from  necessity,  and 
proving  injurious  because  not  a matter  of  every-day  practice.  Violent 
exercise,  more  than  any  other  kind,  must  be  regular  in  order  to  be 
borne. 

Needed  by  Young  Women. — Gymnastic  exercises  and  calisthenics 
are  particularly  needed  by  our  young  women,  to  give  them  something 
of  the  robustness  of  our  mothers,  a few  generations  back.  For  the 


100 


HYGIENE. 


want  of  them,  they  are  dwindling  away,  and  becoming  almost  worth- 
less for  all  the  purposes  for  which  they  were  made. 

In  view  of  this  want  of  exercise  the  introduction  of  the  bicycle 
offers  an  excellent  means  of  development  for  ladies,  and  it  is  very 
gratifying  to  note  its  increasing  use.  It  brings  into  play  many  of 
the  muscles  of  the  body,  while  affording  an  exhilarating  enjoyment 
of  fresh  air  and  changing  scenery.  But  caution  must  be  used,  not  to 
overdo  one’s  self.  Short  rides  only  should  be  taken  at  first,  increas- 
ing the  distance  as  the  muscles  become  hardened. 

Moderns  Physically  Inferior  to  the  Ancients.  Reason  for  it. — 

It  is  evident  that  the  moderns  are  inferior  in  bodily  strength  to  the 
ancient  Greeks  and  Romans.  Before  the  introduction  of  Christianity, 
men  knew  very  little  about  the  future,  and  therefore  strove  to  make 
the  most  of  the  present.  Hence,  they  took  measures  to  ensure  health 
and  long  life.  It  is  true  that  a due  regard  to  the  welfare  of  the  fu- 
ture need  not,  and  should  not,  prevent  a care  for  the  present ; but 
from  various  causes,  to  be  referred  to  on  a subsequent  page,  such  has 
been  the  practice,  to  the  manifest  physical  injury  of  the  race. 

Dancing,  when  hedged  about  with  proper  restrictions  and  limita- 
tions, has  great  advantages  as  a physical  training  for  the  young. 
There  are  very  few  forms  of  exercise  wliich  give  so  free  a play  to  all 
the  muscles,  and  at  the  same  time  so  agreeably  interest  the  mind. 
Begun  in  early  life,  and  pursued  systematically,  dancing  imparts  a 
grace  and  ease  of  motion  which  nothing  else  can  give.  For  this  rea- 
son alone,  it  should  be  cultivated  as  an  art. 

Every  man  and  woman  is  often  placed  in  circumstances  in  life 
where  the  possession  of  an  easy  carriage  of  body,  and  an  unembar- 
rassed manner,  would  be  prized  above  gold.  One’s  personal  influence 
in  tlie  world  is  greatly  increased  by  an  easy,  graceful  manner.  We 
all  know  how  a polite  manner  wins,  while  a rough  and  uncouth  one 
repels  us. 

Warning  against  Excess. — While  dancing  has  many  things  to 
recommend  it,  there  are  also  several  considerations  which  should  warn 
us  against  using  it  to  excess,  particularly  in  the  ball-rooms  of  fashion- 
able life.  So  many  muscles  are  called  into  play,  the  breathing  is  so 
much  quickened,  and  the  air  breathed  is  often  so  impure,  that  the 
circulation  of  the  blood  is  hastened  almost  to  fever  excitement.  And 
when  to  this  we  add  the  use  of  wines  and  cordials,  alternated  with 
ices  and  iced  drinks,  and  the  exposure,  on  returning  home  from  balls, 
to  the  chilly  night  air,  under  the  insufficient  protection  of  light  cloth- 
ing, we  have  drawbacks  enough  to  abridge,  if  not  to  annihilate  the 
benefits  derived  from  this  otherwise  healthful  and  elegant  exercise. 

But  then  it  will  be  said,  and  truly  enough,  that  these  are  the  abuses, 
not  the  uses  of  dancing.  To  these  abuses,  no  parent  should  permit 
the  health  of  a child  to  be  exposed.  In  the  parlor  at  home,  with  a few 
young  friends  gathered  in  to  spend  an  evening ; or,  in  a well-venti- 


HYGieNf;. 


iol 


lated  hall,  under  the  instruction  of  a master  of  known  character  and 
refinement,  dancing  is  of  high  utility,  and  much  may  be  said  in  its 
favor.  An  amusement  for  which  there  is  so  general  a fondness,  one 
may  say,  passion,  must  be  fitted  to  meet  some  want  of  the  animal 
economy,  and  perhaps  of  man’s  higher  nature. 

Grace  of  motion  gratifies  our  sense  of  the  beautiful,  and  in  its  na> 
ture  is  allied  to  poetry.  Turning  away  from  the  abuses  of  dancing, 
let  the  reacder  thankfully  use  it  as  one  of  the  very  best  physical,  so- 
cial, and  aesthetical  educators  of  youth. 

But  if  dancing  is  salutary,  it  is  only  when  every  limb  and  muscle 
is  allowed  to  participate  naturally  and  without  restraint  in  the  general 
motion.  When  performed  in  a dress  so  tight  as  to  restrain  all  free- 
dom, not  only  is  every  grace  destroyed,  but  injury  of  a serious  char- 
acter may  be  the  result. 

The  Cultivation  of  a Garden  is  also  a species  of  exercise  highly 
conducive  to  health.  To  the  poor  it  should  have  a double  attraction. 
It  is  not  only  a healthful  exercise,  but  it  yields,  in  its  season,  many 
wholesome  vegetables,  the  price  of  which,  when  they  have  to  be  pur- 
chased, frequently  puts  them  beyond  their  reach.  It  is  pleasant  to 
know  that  in  many  of  our  manufacturing  towns  the  workmen  own 
small  pieces  of  ground  which  they  cultivate  as  gardens, — deriving 
health  both  from  the  labor,  and  from  the  vegetables  raised.  This  is 
one  of  the  kinds  of  exercise  which  are  more  beneficial  from  having 
an  end  in  view.  The  man  who  works  in  his  garden  derives  pleasure 
from  the  improvement  he  is  making  upon  his  ground,  and  from  the 
prospect  of  advantage  to  himself  and  family. 

' Other  Active  Exercises. — To  the  exercises  already  spoken  of  may 
be  added  those  which  are  mostly  taken  indoors,  — the  dumb-bells, 
jumping  the  rope,  battledore,  etc.  They  may  be  resorted  to  when 
the  weather  is  stormy,  or  when  any  other  cause  may  prevent  one 
from  going  into  the  open  air.  Nevertheless,  as  promoters  of  health, 
they  are  inferior  to  those  exercises  which  take  one  out  under  the 
open  sky.  They  are  too  mechanical  in  their  nature,  and  have  too 
little  aim,  to  be  allowed  to  take  the  place  of  the  preceding. 


Passive  Exercises. 

Sailing. — This,  to  many  persons,  is  among  the  most  pleasurable 
and  exciting  of  the  passive  exercises.  But  the  excitement  arising 
from  the  motions  of  a boat,  sometimes,  in  case  of  timid  persons,  de- 
generates into /ear,  which  is  injurious.  Young  gentlemen  who  man- 
age the  boat  upon  sailing  excursions,  should  never  put  on  too  much 
sail  in  a brisk  wind,  and  torment  the  ladies  by  exciting  their  fears,  as 
their  own  amusement  may  be  in  this  way  purchased  at  the  cost  of 
others’  health, — a result  far  enough  from  their  thoughts  or  inteur 
tions,  but  not  the  less  real. 


102 


HYGIENE. 


Swinging. — The  sick  may  sometimes  indulg  e in  this  exercise,  when 
capable  of  enduring  no  other.-  To  swing  gently  has  a soothing  effect, 
and  often  allays  nervous  irritability  in  a way  which  nothing  else  can. 
It  is  like  the  lullaby  motion  of  the  cradle.  It  calms  and  soothes. 

Nervous  children  and  grown  persons  in  feeble  health  are  some 
times,  by  roguish  boys,  swung  too  high,  and  very  much  excited  and 
alarmed.  This  is  wrong.  It  may  do  great  injury.  Very  few  boys 
would  do  it  if  they  knew  the  evil  consequences.  Boys  and  girls  are 
generally  kind-hearted ; and  though  they  may  like  to  hector  others, 
they  will  seldom  knowingly  injure  them  for  their  own  amusement. 

Carriage-Riding, — The  advantages  to  be  derived  from  this  species 
of  exercise  are  probably  rated  too  high.  For  feeble  persons,  just  re- 
covering from  illness,  who  cannot  endure  walking  or  riding  on  horse 
back,  it  is  valuable,  particularly  if  taken  in  an  open  carriage.  But  for 
those  who  have  more  strength,  it  is  less  desirable  than  many  other 
exercises.  True,  it  is  generally  an  agreeable  mode  of  locomotion,  and 
for  this  reason,  it  is  more  serviceable  than  the  small  amount  of  exer- 
cise afforded  by  it  would  lead  one  to  suppose. 

Carriages  are  luxuries,  and  like  all  other  luxuries,  they  are  apt  to 
bring  on  debility,  and  perhaps  shorten  life.  A man  is  apt  to  order 
his  carriage  to  the  door  at  the  time  wdien  increasing  wealth  enables 
him  to  retire  from  the  active  pursuits  of  life,—  the  very  moment  when 
he  is  most  in  need  of  some  exertion  to  take  the  place  of  that  to  which 
he  has  been  accustomed.  Yet  so  it  is,  luxury  comes  to  enfeeble,  at 
the  time  when  we  need  something  to  harden  us. 

Could  rich  men  be  persuaded  to  let  their  luxuries  consist,  in  part, 
in  doing  good,  and,  like  Howard,  find  pleasure  in  travelling  on  foot 
to  visit  those  who  are  sick  and  in  prison,  they  would  be  surprised  to 
see  how  their  happiness  would  be  increased. 

Close  carriages  are  generally  used  by  the  wealthy.  They  at  best 
contain  but  little  air,  which  is  breathed  over  and  over,  and  becomes 
unfit  for  respiration.  The  windows  of  such  carriages  should  always 
be  open,  except  in  rainy  weather,  when  the  latticed  windows  only 
should  be  used. 

Riding  in  Sleighs  furnishes  an  agreeable  excitement,  and  may  be 
indulged  in  to  some  extent  with  advantage.  Yet  it  can  be  had  only 
in  cold  weather,  and  persons  who  partake  of  its  pleasures  should  be 
careful  to  wear  clothing  enough  to  protect  themselves  against  the 
frost.  This  is  the  more  necessary,  as  very  little  motion  is  communi- 
cated to  their  bodies  by  the  sleigh. 

Horseback  Riding. — This  form  of  exercise  may  fairly  rank  next 
to  walking ; in  some  states  of  the  system  it  is  preferable.  It  justly 
holds  a high  rank  as  an  exercise  for  consumptive  persons.  Many  a 
man,  and  woman  too,  has  been  benefited  by  it  when  suffering  from 
lung  disease.  For  those  who  have  hernia,  or  falling  of  the  bowel,  it 
is  not  proper,  as  the  most  serious  consequences  may  result  from  its 
use. 


HYGIENE. 


103 


The  Horse  should  be  Owned, — A feeble  man  who  rides  on  horse- 
back, should,  if  possible,  own  his  horse ; for,  becoming  attached  to 
him,  as  he  generally  does,  he  will  be  able  to  ride  farther  than  upon 
an  animal  in  which  he  feels  less  interest.  A horse  is  a noble  crea- 
ture, and  a man  who  loves  him  will  sometimes  acquire  a passion, 
almost,  for  beingupon  his  back,  and  witnessing  his  splendid  perform- 
ances. 

Pleasurable  Exercises  most  Beneficial. — Finally,  those  exercises 
are  most  beneficial,  and  can  be  longest  endured,  in  which  we  feel  the 
greatest  interest.  Place  before  even  a feeble  man  some  desirable  ob- 
ject, and  he  will  endure  a great  deal  to  reach  it;  or  engage  the  mind 
of  a very  tired  person  in  something  which  greatly  interests  it,  and 
considerably  more  exertion  will  be  easily  borne.  This  is  well  illus- 
trated by  the  story  told  by  Miss  Edgeworth  of  a certain  father,  who 
had  taken  a long  walk  with  his  little  son,  and  found  the  boy  appar- 
ently unable  to  walk  further,  some  time  before  reaching  home. 
“ Here,”  said  the  shrewd-minded  father,  “ ride  on  my  gold-headed 
cane.”  Immediately  the  little  fellow  was  astride  the  cane,  which 
carried  him  as  safely  home  as  the  freshest  horse. 

Mental  Co-operation  is  of  the  highest  importance  in  all  exercise. 
Men  who  are  paid  by  the  job,  work  with  far  more  spirit  than  those 
who  are  paid  by  the  day.  One  would  dig  in  the  earth  with  very 
little  spirit,  if  he  had  no  motive  for  doing  it ; but  if  expected  with 
every  shovelful  of  earth  to  bring  up  gold-dust,  he  would  not  only 
work  with  a will,  but  would  endure  a great  deal  more  labor.  From 
these  considerations  we  may  infer  that  those  farmers  and  manufac- 
turers who  pay  their  men  the  highest  wages,  make  the  most  money 
on  their  work. 

The  best  time  for  taking  exercise  is  that  in  which  it  does  us  most 
good.  For  most  persons  the  morning  hours  may  be  considered  most 
favorable.  But  there  are  many  who  cannot  take  exercise  in  the  early 
morning,  without  suffering  from  it  through  the  Avhole  day.  Some 
are  able  to  walk;  miles  in  the  afternoon,  who  would  be  made  sick  by 
similar  exertions  immediately  after  rising. 

Persons  often  injure  friends  who  have  this  peculiarity  of  constitu- 
tion by  urging  them  out  in  the  morning.  They  do  it  from  good  mo- 
tives, but  are,  nevertheless,  blameworthy  for  attempting  to  advise  in 
matters  which  they  do  not  understand. 


Rest  and  Sleep. 

Ottr  bodies  are  like  clocks ; they  run  down  and  are  wound  up  once 
every  twenty-four  hours.  Were  they  obliged  to  work  on  uninter- 
ruptedly, they  would  wear  out  in  a few  days.  It  is  a merciful  pro- 
vision that  periods  of  repose  are  allotted  to  us.  Evervthing  has  its 


104 


HYGIENE. 


proper  place.  Rest  is  not  less  a luxury  after  exercise,  than  exercise 
is  aher  rest.  They  both  confer  happiness  at  the  same  time  that  they 
promote  our  well-being. 

Sleeping  Rooms, — 'J'he  largest  part  of  our  rest  is  taken  in  sleep. 
Of  course  the  kind  of  room  in  which  we  sleep  is  worthy  of  considera- 
tion. Huf eland  says:  “It  must  not  be  forgotten  that  we  spend  a 
considerable  portion  of  our  lives  in  the  bed-chamber,  and  consequently 
that  its  healthiness  or  unhealthiness  cannot  fail  to  have  a very  im- 
portant influence  upon  our  physical  well-being.”  It  should  at  least 
be  large.  That  is  of  prime  importance,  because,  during  the  several 
hours  that  we  are  in  bed,  we  need  to  breathe  a great  deal  of  air,  and 
our  health  is  injured  when  we  are  obliged  to  breathe  it  several  times 
over.  We  should  at  least  pay  as  much  attention  to  the  size,  situa- 
tion, temperature,  and  cleanliness  of  the  room  we  occupy  during  the 
hours  of  repose,  as  to  the  parlors,  or  drawing-room,  or  any  other 
apartment.  And  yet  how  different  from  this  is  the  general  practice 
of  families.  The  smallest  room  in  the  house  is  commonly  set  apart 
for  the  bed  and  its  nightlj^  occupants. 

The  sleeping-room  should  have  a good  location,  so  as  to  be  dry. 
It  should  be  kept  clean,  and  neither  be  too  hot  nor  too  cold.  And, 
more  important  still,  it  should  be  well  ventilated. 

One  bed,  occupied  by  two  persons,  is  as  much  as  should  ever  be 
allowed  in  a single  room;  though,  of  course,  two  beds  in  a large  room 
are  no  more  than  one  in  a small  one.  Both  are  objectionable. 

Fire  in  Sleeping  Rooms. — As  to  having  fire  in  a sleeping  room, 
that  is  a matter  to  be  determined  by  the  health  of  the  occupant. 
Persons  who  have  poor  circulation,  and  are  feeble,  had  better  have  a 
little  fire  in  the  bed-chamber  in  cold  weather.  For  those  in  good 
health  a cold  room  is  preferable. 

Open  Windows  in  Sleeping  Rooms. — In  the  hot  weather  of  sum- 
mer, it  is  better  to  keep  the  windows  open  to  some  extent,  through 
the  night,  but  not  on  opposite  sides  of  the  room  so  as  to  make  a draft 
across  the  bed. 

There  is  a difference  of  opinion  as  to  the  safety  of  this  practice, 
but  the  experience  of  those  who  have  used  it  prudently  and  persever- 
ingly  has  generally  sanctioned  its  employment.  It  is  presumed  that 
night-air  is  made  to  be  breathed;  and  if  we  breathe  it  habitually, 
there  is  no  good  reason  why  it  should  be  considered  hurtful.  At  all 
events  we  have  got  to  do  one  of  three  things, — either  breathe  it,  or 
be  poisoned  by  air  which  is  breathed  several  times  over,  or  use  very 
large  sleeping  rooms,  and  then  lay  in  a stock  to  last  over  night. 

An  Open  Fireplace  in  a bed-chamber  will  do  much  towards  its 
purification.  It  carries  off  foul  air.  But  many  persons  board  up  this 
outlet  as  if  bad  air  were  a friend  with  whom  they  could  not  think  of 
parting.  At  the  same  time  they  will  carefully  close  all  windows  and 
doors,  as  if  fresh  air  were  an  enemy  not  to  be  let  in. 


HYGIENE. 


105 


Beds. It  is  a pleasant  thought  that  while  so  many  things  whicl) 

injure  health  are  coming  into  fashion,  some  which  have  a like  effect 
are  going  out.  Among  the  injurious  things  which  are  silently  with- 
drawing are  feather-beds. 

In  earlier  times,  a bed  made  of  eider-down  was  thought  to  be  a 
great  luxury,  to  be  carefully  preserved,  and  handed  down  from  mother 
to  daughter.  Beds  made  of  hen’s  feathers,  and  other  coarser  kinds, 
were  thought  to  be  only  fit  for  children.  With  due  deference  to 
these  earlier  judgments,  it  must  be  said  that  feather  beds,  whether 
downy  or  coarse,  are  not  even  fit  for  children.  They  are  composed 
of  animal  matter,  and  by  a slow  process  of  decay,  are  always,  when 
stirred,  sending  up  an  exhalation  which  it  is  not  healthful  to  breathe. ' 

By  their  softness,  too,  they  increase  the  general  tendency  to  effemi- 
nacy. In  warm  weather  they  are  too  heating.  To  sink  down  into 
them,  and  lie  nearly  buried  all  night,  is  to  insure  a feeling  of  lassi- 
tude and  debility  in  the  morning.  Only  the  strongest  persons  can 
endure  it  without  being  made  conscious  of  the  evil  effects. 

Beds  must  not  be  too  Hard. — On  the  other  hand,  it  is  almost 
equally  unwise  to  choose  a bed  of  absolutely  unyielding  hardness. 
When  very  tired,  we  may  rest  even  upon  a board ; but  sleep  will 
generally  be  more  sound  as  well  as  refreshing,  if  the  bed  be  some- 
what }delding.  The  hair  mattress  is  the  very  best  bed  yet  used.  It 
is  healthful  and  easy.  No  person  once  accustomed  to  it  will  ever 
return  to  feathers  In  summer,  it  is  a luxury  ; in  winter,  it  is  suffi- 
ciently warm,  though  a little  more  covering  is  needed  than  with 
feathers. 

Bedding. — In  hot  weather,  linen  sheets  are  preferable  to  cotton, 
and  of  course  will  be  used  by  those  who  have  ample  means.  But 
cotton  ones  are  good  enough,  and  in  winter  are  decidedly  the  more 
desirable  of  the  two.  Cotton  is  best,  too,  for  those  who  suffer  with 
rheumatic  affections.  For  external  covering,  comforts  are  objection- 
able, because  they  do  not  let  the  insensible  perspiration  pass  off  as 
freely  as  it  should.  They  are  light,  however,  and  so  are  rose  blankets, 
which  have  the  additional  good  quality  of  being  porous.  We  should 
sleep  under  as  few  clothes  as  possible,  consistently  with  comfort. 

Night-Dress.  — The  flannel,  cotton,  linen,  or  silk,  worn  next  the 
skin  through  the  day,  should  always  be  replaced,  on  retiring,  by  a 
suitable  night-dress.  The  undershirt  should  be  of  the  same  ma- 
terial with  that  which  is  taken  off,  but  thinner.  If  we  wear  flannel 
through  the  day,  we  need  it  quite  as  much  at  night. 

Do  not  Cover  the  Face.  — The  practice  of  sleeping  with  the  face 
entirely  covered  with  the  bed-clothes  is  very  injurious.  It  compels 
one  to  breathe  the  air  over  several  times. 

Natural  Position  for  Sleep.  — The  most  natural  position  in  which 
to  sleep  is  upon  the  right  side.  This  affords  the  easiest  play  to  the 


106 


HYGIENE. 


internal  organs.  It  is  best,  however,  to  learn  to  sleep  in  different 
positions,  and  to  change  occasionally  from  side  to  side.  Upon  the 
back  is  not  so  easy  a position.  To  lie  in  this  way  obstructs  the  cir- 
culation of  the  blood,  by  the  pressure  of  the  stomach,  bowels,  etc., 
upon  the  large  blood-vessels  which  pass  down  and  up  in  front  of  the 
backbone.  It  is  very  tiresome  and  injurious  to  lie  ivith  the  hands 
above  the  head. 

Amount  of  Sleep.  — The  average  amount  of  sleep  required  by 
persons  in  health  is  from  seven  to  eight  hours.  Occasionally  we  find 
persons  who  get  along  very  well  with  six,  or  even  five  hours ; while 
some,  even  in  health,  require  nine.  There  is  no  absolute  standard 
for  all  persons,  in  the  amount  of  sleep,  any  more  than  in  that  of 
food.  It  depends  on  the  temperament,  the  constitution,  the  amount 
of  exercise,  and  the  exhausting  nature  of  the  mental  application. 

The  object  of  sleep  is  to  repair  the  energies,  the  extent  to  which 
they  are  wasted,  and  the  recuperative  power  possessed,  will  measure 
the  amount  required. 

Late  Suppers.  — These  are  a bar  to  all  sound  and  healthful  sleep. 
The  last  meal  should  always  be  taken  at  least  three  hours  before  re- 
tiring and  should  be  light.  During  sleep  the  stomach  should  have  a 
chance  to  rest.  It  will  work  the  better  on  the  morrow.  Some  per- 
sons boast  that  they  can  sleep  perfectly  well  after  a heavy  supper. 
Perhaps  they  can,  but,  as  Franklin  has  wisely  suggested,  they  may 
by  and  by  “ have  a fit  of  apoplexy,  and  sleep  till  doomsday.”  This 
will  be  sleeping  too  well! 

Preparation  for  Sleep. — Dr.  Franklin  left  behind  the  record  ol 
a wise  life,  as  well  as  many  excellent  moral  and  philosophical  direc- 
tions. A good  conscience  was  his  prescription  for  quiet  sleep  and 
pleasant  dreams,  — a most  excellent  direction.  Sleep  is  promoted, 
too,  by  withdrawing  the  mind,  a short  time  before  retiring,  from  all 
hard  study  and  exciting  themes  of  conversation,  and  turning  it  to 
calmer  subjects  of  reflection,  such  as  the  moral  attributes  of  God,  and 
particularly  his  love  and  paternal  character 

Objects  of  Clothing. 

The  clothes  we  wear  are  intended,  or  should  be  intended,  to  secure 
three  objects, — warmth  in  winter.,  coolness  in  summer.,  and  health  at  all 
times. 

It  has  already  been  shown  that  our  bodies  are  warmed  by  their 
own  internal  fires.  In  the  lungs,  in  the  skin,  and  indeed  in  all  parts 
of  the  body,  oxygen  unites  with  carbon  and  other  combustible  mat- 
ters, producing  heat  in  the  same  way  that  it  is  produced  in  a grate 
where  coal  is  burned  ; and  as  our  temperature  always  needs  to  be  kept 
to  about  98°  Farenheit,  it  follows  that  this  combustion  must  always 
be  going  on. 


HYGIENE. 


107 


Now,  the  atmosphere  which  surrounds  us  is  always  receiving  into 
itself  the  heat  which  comes  to  the  surface  of  our  bodies,  and  thus 
robbing  us  of  our  warmth.  In  summer,  the  atmosphere,  full  of  the 
rays  of  a burning  sun,  may  impart  heat,  instead  of  taking  it  away ; 
wliile  in  winter  it  takes  more  than  it  gives,  and  would  cause  us  to 
perish  with  the  cold,  were  it  not  for  the  protection  afforded  by  our 
clothing. 

Clothes,  of  course,  have  no  power  to  manufacture  or  impart  heat. 
They  only  retain,  and  keep  in  contact  with  our  bodies,  that  which  is 
generated  within  us.  If  we  have  on  a single  garment  which  is  made 
tight  at  the  bottom  and  top,  so  that  no  current  can  pass  up  or  down, 
there  will  be  a layer  of  air  between  it  and  the  body,  which,  becoming 
immediately  heated,  and  being  retained  there,  helps  keep  us  warm,  or 
rather,  prevents  us  from  being  cold.  With  every  additional  garment 
put  over  this,  there  is  another  layer  of  heated  air,  adding  still  more 
impenetrable  guards  against  either  the  intrusion  of  cold,  or  the  escape 
of  internal  heat. 

Bad  Conductors  of  Heat. — But,  that  our  clothes  may  thus  retain 
our  warmth,  and  prevent  its  dispersion,  they  must  be  bad  conductors 
of  heat, — that  is,  they  must  not  readily  take  up  the  heat  and  convey 
it  away  from  the  body.  They  must  slowly  absorb  the  caloric  into 
their  own  substance,  and  then  retain  it  tenaciously. 

Linen,  which  is  so  universally  popular  in  temperate  climates,  as 
an  article  to  be  worn  next  the  skin,  is  unfortunately  a good  conduc- 
tor of  heat.  It  does  not  afford  a warm  garment.  It  conducts  heat 
rapidly  away  from  the  body.  Hence  it  always 
feels  cool  to  the  touch.  It  is  really  no  colder  in 
itself  than  other  kinds  of  cloth,  but  it  is  solely 
the  rapidity  with  which  it  conducts  heat  away 
from  the  body,  that  gives  it  the  feeling  of  cold- 
ness. It  has  other  qualities  which  compensate, 
in  some  measure,  for  this  defect.  The  fibres  of  which  it  is  composed 
are  round  and  pliable,  which  makes  linen  cloth  smooth  and  soft,  and 
the  sensations  produced  by  it  on  the  skin  altogether  agreeable.  Fig. 
67  represents  a fibre  of  linen,  as  it  appears  under  a microscope  which 
magnifies  it  165  times. 

Cotton  is  warmer  than  linen,  because  it  is  a worse  conductor  of 
heat.  The  perfection  to  which  its  manufacture  has  been  carried, 
makes  it  almost  a rival  of  linen  in  softness  and  pliability.  It  does 
not  absorb  as  much  moisture  as  linen,  and  there 
fore  better  retains  its  powers  as  a non-conductor. 
But  then  the  fibres  of  cotton  are  not  round  and 
smooth,  like  those  of  linen,  but  flat  and  spiral, 
with  sharp  edges.  Fig.  68  represents  two  of  its 
fibres,  magnified  155  times.  This  renders  cotton 
irritable  to  some  very  delicate  skins.  This  is  the  reason  why  linen 


Fig.  68. 


Fig.  67. 


• 108 


HYGIENE. 


is  better  than  cotton  for  binding  up  wounds,  where  there  is  tender- 
ness of  the  surface. 

Silk  has  a round  fibre,  like  linen,  which  is  even  softer  and  smaller. 
It  absorbs  less  moisture  than  cotton,  and  in  its  power  of  retaining 
warmth,  it  is  superior  to  both  the  preceding.  It  forms  the  most  de- 
sirable fabric  for  clothing  that  we  have  ; but  its  cost  makes  it  inacces- 
sible to  the  great  body  of  the  people,  except  as  a holiday  dress  for 
the  ladies.  Its  culture  in  our  country,  if  extensively  established, 
would  be  a source  of  national  wealth. 

The  Fibre  of  Wool  is  quite  rough,  almost  scaly,  and  highly  irrita- 
tive to  delicate  skins.  Fig.  69  shows  fibres  magnified  310  times.  It 
is  not  possible  for  some  persons  to  wear  it  next 
the  skin.  But  where  this  cannot  be  done  it  may 
be  worn  outside  the  linen  or  cotton ; and  being  a 
good  non-conductor,  it  will  in  this  way  preserve 
the  warmth  of  the  body,  without  either  irritating 
the  skin,  or  disturbing  its  electricity. 

Wool,  in  cold  climates,  is  one  of  the  very  best 
materials  of  which  clothes  can  be  made.  In  New 
England,  and,  indeed,  in  all  cold  and  temperate 
regions,  it  should  be  worn  by  delicate  persons,  in 
the  form  of  thick  or  thin  garments,  all  the  year  round.  It  does  not 
readily  absorb  moisture,  and  is  a dry,  warm,  and  wholesome  material 
for  clothing. 

Hair. — Though  not  precisely  in  the  line  of  these  remarks,  hair 
may  as  well  be  introduced  here.  Wool  is  in  fact  hair.  Every  part 
of  the  skin,  with  the  exception  of  that  upon  the  soles  of  the  feet,  and 
the  palms  of  the  hands,  is  intended  to  produce  hairs.  On  most  parts 
of  the  body,  they  are  short  and  fine,  hardly  rising  above  the  surface. 
Upon  the  head  and  the  face,  they  grow  to  considerable  length. 

Hair,  like  wool,  is  a bad  conductor  of  heat ; and,  as  growing  upon 
the  head  and  face,  is  doubtless  intended  for  some  useful  purpose. 
That  it  was  designed  as  a warm  covering,  can  hardly  be  doubted. 
The  beard,  when  permitted  to  grow,  is  a natural  respirator,  guarding 
the  lungs  against  cold  and  dust.  It  has  been  noticed  that  black- 
smiths who  have  allowed  their  beards  to  grow,  had  their  mustache 
discolored  by  iron-dust,  which  lodged  among  the  hairs,  and  very 
justly  inferred  that  the  dust  must  have  found  its  way  into  the  lungs, 
and  done  mischief,  had  it  not  been  arrested  by  this  natural  respirator. 

That  the  beard,  when  long,  does  ward  off  a great  many  colds  and 
throat  troubles,  is  too  well  known  to  be  denied.  It  has  required  moral 
courage  on  the  part  of  those  who  have  broken  away 
from  the  universal  practice  of  shaving,  for  which  they 
should  be  honored  rather  than  ridiculed.  For  those 
who  do  not  suffer  from  throat  or  lung  complaints,  espe- 
cially if  they  are  getting  advanced  in  life,  it  may  not  be 
thought  worth  while  to  abandon  the  razor.  Yet  the  change  would 


Fig,  70. 


HYGIENE. 


109 


not  be  regretted.  Fig.  70  is  a human  hair,  magnified  250  times, 
showing  ite  scaly  surface. 

The  Color  of  our  Clothing  is  a matter  of  some  moment.  The  dark 
colors  absorb  the  light,  the  sun’s  rays,  and  heat,  much  more  than  the 
lighter  ones ; and  as  those  bodies  which  absorb  heat  well  are  likewise 
good  radiators,  the  dark  colors  have  the  highest  radiating  power.  White 
reflects  heat  and  rays  of  light,  and  is  a bad  absorber  and  bad  radiator. 
In  summer  it  prevents  the  sun’s  rays  from  passing  inward  to  heat  the 
body,  and  in  winter,  interrupts  the  heat  of  the  body  in  its  passage 
out.  In  summer,  it  makes  the  coolest  garment ; in  winter  the  warmest 
one.  These  facts  can  be  very  simply  illustrated,  by  laying,  side  by 
side,  upon  the  snow,  when  the  sun  shines,  two  pieces  of  cloth,  the 
one  black,  the  other  white.  Lifting  them  up,  after  a time,  the  snow 
will  be  found  considerably  melted  under  the  black  cloth,  hut  not  under 
the  white. 

It  is  now  seen  that  the  object  of  clothing  is  not  to  impart  heat  to 
the  body,  but  to  prevent  its  loss ; that  it  is  not  to  create  it,  but  to 
furnish  the  occasion  for  increasing  its  degree.  It  appears  further, 
that  clothing  protects  the  body  against  the  evil  effects  of  changes  of 
temperature,  and  that  white  garments,  hy  reflecting,  instead  of  ab- 
sorbing heat,  guard  it  against  the  heat  of  summer. 

Clothing  should  be  Porous. — All  articles  used  for  garments  should 
be  porous,  and  permit  the  free  passage  of  insensible  perspiration.  The 
skin  receives  oxygen  through  its  pores,  and  gives  back  carbonic  acid. 
It  performs  a sort  of  subordinate  respiration.  India-rubber  garments, 
worn  next  to  it,  interrupt  this,  and  must  do  mischief.  Shoes  made 
of  this  material  soon  cause  the  feet  to  become  damp  and  cold.  The 
dampness  is  occasioned  by  the  insensible  perspiration,  which  cannot 
escape  through  the  rubber.  Such  shoes  worn  in  the  open  air,  should 
be  immediately  taken  off  on  entering  the  house. 

Thin  Shoes. — The  defective  way  in  whieh  American  females  pro- 
tect their  feet  from  cold  and  wet,  is  a sore  evil;  and  he  who  persuades 
them  to  adopt  a wiser  fashion,  and  cover  their  feet  with  better  guards 
against  colds  and  consumption,  will  deserve  the  gratitude  of  the  na- 
tion. We  are  in  many  things  too  fond  of  copying  foreign  fashions; 
but  if  our  ladies  would,  in  this  matter,  follow  the  excellent  example 
of  English  women,  they  would  live  longer,  and  leave  a hardier  pos- 
terity behind  them. 

The  shoes  worn  by  our  females,  high  and  low,  rich  and  poor,  are 
not  thick  enough  to  walk  with  safety  upon  a painted  floor,  hardly 
upon  a carpet  in  an  un warmed  room;  and  yet  they  walk  with  them 
upon  cold  brick  sidewalks,  upon  damp  and  frozen  ground,  and  even 
in  mud. 

The  result  is,  that  they  suffer  from  colds,  sore  throats,  pleurisies, 
lung-fevers,  suppressions,  inflammations  of  the  womb,  and  many  other 
ailments,  which  in  early  life  rob  them  of  their  freshness  and  beauty. 


no 


HYGIENE. 


of  their  health  and  comfort,  of  their  usefulness  to  their  household 
and  the  world,  and  leave  them  helpless  in  the  arms  of  their  friends, 
with  a patrimony  of  suffering  for  themselves  while  they  live  and  a 
legacy  of  disease  to  hand  down  to  their  children.  Would  that  they 
were  wise  in  season ! Some,  to  their  honor  be  it  said,  have  already 
adopted  a safer  course.  It  is  hoped  the  evil  will  be  gradually  cor- 
rected. 

Never  attempt  to  mould  the  Form  by  Dress. — Parents  commit  a 
great  error  when  they  attempt  to  mould  the  forms  of  their  children, 
particularly  their  daughters,  by  their  dress.  This  cannot  be  done. 
It  IS  the  worlv  of  nature,  and  she  Avants  no  assistance  in  it.  T'he 
great  object  of  dress  in  childhood,  as  well  as  in  adult  life,  is  to  pro- 
mote health.  With  this,  there  is  not  much  difficulty  in  preserving 
the  symmetry ; without  it,  deformity  is  almost  a matter  of  course. 

The  fact  cannot  be  too  often  repeated,  nor  too  seriously  urged  upon 
parents,  that  wliile  the  foundation  of  ail  graceful  and  just  proportion 
of  the  different  parts  of  the  body  must  be  laid  in  infancy,  it  cannot 
be  done  by  tight  bands,  and  ligatures  upon  the  chest,  and  loins,  and 
legs,  and  arms.  Upon  all  these  points,  the  garments  of  children 
should  set  easy,  leaving  the  muscles  at  liberty  to  assume  the  fine 
swell  and  development  which  nothing  short  of  unconstrained  exercise 
can  give.  Could  infants  tell  all  the  horrors  they  suffer  from  the  re- 
straints put  upon  them  by  tight  dresses,  it  would  make  many  a 
mother’s  heart  bleed. 

In  these  brief  remarks,  the  principles  are  given  which  should  guide 
us  in  the  selection  of  our  clothing.  The  intelligent  reader  will  be 
able  very  easily  to  fill  up  the  outline. 

Bathing  and  Cleanliness. 

Aristotle  calls  cleanliness  one  of  the  half  virtues ; and  Addison, 
in  the  Spectator,  recommends  it  as  a mark  of  politeness,  and  as  analo- 
gous to  purity  of  mind.  Both  in  the  Jewish  and  Mohammedan  law, 
it  is  enforced  as  a part  of  religious  duty.  Its  requirement  as  a pre- 
requisite to  Christian  communion  would  be  wiser  than  the  demands 
sometimes  made.  A dirty  Christian  may  perhaps  be  found,  but  not 
among  those  who  mean  to  be  intelligent. 

The  importance  of  keeping  the  skin  clean  is  not  generally  appreci- 
ated. The  motive  for  cleanliness  is  often  a lower  and  meaner  one 
than  should  be  allowed  to  have  place  in  the  mind.  Many  persons 
would  be  mortified  to  have  their  hands,  or  face,  or  neck  dirty,  who 
do  not  wash  their  whole  body  once  a year.  That  they  may  appear 
well  in  the  eyes  of  others,  is  the  only  motive  with  such  for  keeping 
clea^i. 

Offices  of  the  Skin. — If  we  look  a little  at  the  offices  of  the  skin, 
we  shall  better  understand  the  need  of  keeping  it  clean. 


fiYGlENE. 


Ill 


The  skin  is  not  merely  a covering  to  protect  us  from  the  weather. 
It  is  a living  structure,  curiously  wrought,  with  a large  extent  of  sur- 
face, and  having  important  duties  to  perform  in  the  animal  economy. 
Its  structure  is  more  particularly  explained  under  the  head  of  “ Anat- 
omy ” and  “ Skin  Diseases.”  It  has  been  already  said,  that  it  helps 
the  lungs  in  breathing.  It  does  many  other  things  on  which  the  health 
is  dependent. 

Number  of  Perspiratory  Tubes.  — The  skin  performs  several 
kinds  of  secretion,  — that  is,  it  separates  several  things  from  the 
blood, — one  of  which  is  the  perspiration,  or  sweat.  The  sweat  is 
formed  in  small  glands,  situated  just  under  the  skin,  and  is  brought 
to  the  surface  in  small  ducts,  or  tubes,  like  the  hose  thiough  which 
fii'emen  throw  water.  These  little  tubes  are  spiral,  as  seen  in  cut  44, 
and  run  up  through  the  two  skins. 

These  spiral  canals  are  very  numerous,  covering  every  part  of  the 
human  frame,  — there  being  about  2800  of  them  upon  every  square 
inch  throughout  the  body ; and  as  a man  of  ordinary  size  has  about 
2500  square  inches  of  surface,  the  numbei'  of  tubes  in  the  skin  of  one 
man  is  seven  millions. 

The  mouths  of  these  tubes  are  called  the  pores  of  the  skin.  Each 
one  of  these  tubes  is  extended  just  below  the  skin ; and  there,  among 
the  cells  where  the  fat  is  deposited  it,  or  rather  the  two  branches  into 
which  it  is  divided,  is  wound  into  a coil,  called  the  sudoriferous  or 
sweat  gland.  These  ducts  are  each  about  a quarter  of  an  inch  in 
length,  which  make  an  aggregate  length  of  tubing  in  the  human  skin 
of  about  twenty-eight  miles. 

Insensible  Perspiration. — Through  each  of  these  seven  million  of 
quarter-inch  hose,  there  is  poured  out,  day  and  night,  as  long  as  a 
man  lives,  a stream  of  sweat  in  the  form  of  vapor.  When  this  is 
thrown  off  very  rapidly,  as  happens  when  active  exercise  is  taken,  it 
accumulates  in  drops,  and  is  called  sweat.  Ordinarily  it  does  not 
thus  accumulate ; it  is  then  called  insensible  perspiration,  — not 
being  recognized  by  the  senses. 

This  transpiration  may  be  proved  very  beautifully  by  inserting  the 
naked  arm  into  a long  glass  jar,  and  closing  up  the  space  around  it 
at  the  mouth  so  that  no  air  can  get  in.  The  inside  of  the  glass  will 
soon  be  covered  with  a vapor,  which  will  grow  more  and  more  dense 
until  it  is  converted  into  drops.  Boerhaave  says  : “ If  the  piercing 
chill  of  winter  could  be  introduced  into  a summer  assembly,  the  in- 
sensible perspiration  being  suddenly  condensed,  would  give  to  each 
person  the  appearance  of  a heathen  deity,  wrapped  in  his  own  sepa- 
rate cloud.” 

Now,  this  continual  exudation  of  sweat  through  these  millions  of 
tubes  is  for  a wise  and  necessary  purpose.  It  is  to  take  out  of  the 
blood  and  other  fluids  various  salts,  which  would  do  mischief  if 
allowed  to  remain  longer,  and  particularly  carbonic  acid,  which  is 


112 


HYGIENE. 


poisonous,  — the  same  matters,  in  fact,  which  are  tlu-own  out  by  the 
lungs.  The  skin,  in  truth,  is  a kind  of  helper  of  the  lungs ; and  a 
lady,  by  covering  herself  with  garments  which  have  no  pores,  and 
will  neither  admit  air  nor  let  off  insensible  perspiration,  may  be 
strangled  almost  as  certainly  as  by  putting  a cord  around  her  neck, 
and  closing  her  windpipe.  Almost  twice  as  much  fluid  passes  off 
through  the  skin  as  through  the  lungs. 

Keep  the  Pores  Open.  — It  is  obvious  from  what  has  now  been 
said,  that  the  pores  of  the  skin  should  be  kept  open  to  preserve 
health.  When  bathing  is  neglected,  and  the  undergarments  are  not 
changed  sufficiently  often,  the  insensible  perspiration  accumulates 
and  dries  up  upon  the  skin,  mingling  with  the  oily  matter  secreted 
by  the  oil-glands,  and  with  the  slireds  of  the  scarf-skin,  and  form- 
ing a tenacious  gluey  matter,  which  closes  up  the  pores.  By  this 
misfortune,  that  large  quantity  of  worn-out  matter  which  usually 
goes  off  with  the  fluid  through  the  pores  is  retained  to  poison  and 
embarrass  the  living  current  of  blood,  or  seek  an  outlet  through  lungs 
or  kidneys,  which  are  already  burdened  with  quite  as  much  as  they 
are  able  to  do.  How  important,  then,  that  these  channels  through 
which  the  body  is  purified  should  be  kept  open  ! that  the  skin  should 
be  kept  healthy  and  in  working  order  ! 

The  Bath,  the  Great  Purifier.  — But  this  can  only  be  done  bj 
daily  washing.  The  bath  is  the  great  purifier  of  the  human  skin. 

The  antiquity  of  bathing  is  very  great.  The  practice  is  supposed 
to  reach  back  to  the  infancy  of  the  race,  or  certainly  to  a very  early 
period.  The  inhabitants  of  Middle  Asia  are  said  to  have  been  the 
first  to  use  the  bath  for  the  specific  purposes  of  purification  and 
health.  Domestic  baths  are  represented  as  having  been  used  by 
Diomed  and  Ulysses.  Andromache  prepared  warm  water  for  Hector 
on  his  return  from  battle.  Penelope  banished  sorrow  by  unguents 
and  baths. 

The  Baths  of  the  Medes,  the  Persians,  and  the  Assyrians  were 
much  celebrated.  Alexander,  though  familiar  with  the  voluptuous 
baths  of  Greece  and  Macedon,  was  astonished  at  the  magnificence  of 
those  of  Darius. 

Roman  Baths.  — As  luxury  and  refinement  advanced,  the  means 
of  luxurious  bathing  were  multiplied,  until  establishments  were 
built  by  the  Romans,  the  very  remains  of  which  excite  wonder  at 
this  day.  Among  these  are  the  Thermae  of  Agrippa,  of  Nero,  of 
Vespasian,  of  Titus,  etc.  One  of  the  halls  of  the  building  con- 
structed for  baths  by  Diocletian,  forms  at  this  day  the  church  of  the 
Carthusians,  one  of  the  most  magnificent  temples  in  Rome. 

Number  and  Character.  — According  to  Pliny,  baths  were  intro- 
duced into  Rome  about  the  time  of  Pompey ; their  first  erection 
Dion  attributes  to  Maecenas.  Agrippa  increased  their  number  to 


HYGIENE. 


113 


one  hundred  and  seventy ; and  within  two  hundred  years  they  were 
multiplied  to  about  eight  hundred.  These  establishments  were  so 
vast  that  one  writer  compares  them  to  provinces.  They  were  paved 
either  with  crystal,  or  mosaic,  or  plaster,  and  were  adorned  by  sculp- 
ture and  painting  to  the  very  highest  degree.  They  added  not 
merely  to  the  health  and  luxury  of  the  people,  but  contributed  to 
their  culture  in  the  highest  departments  of  art  and  taste. 

Names  of  Baths.  — To  the  apartment  of  their  dwelling  in  which 
they  washed  their  bodies  in  warm  or  hot  water,  the  Romans  gave 
the  name  of  balneum,  or  bath ; to  the  public  establishments,  that  of 
balnea,  or  baths.  The  apartment  which  held  the  vessels  was  called 
vasarium.  In  this  were  the  three  immense  vessels  which  contained 
the  cold,  warm,  and  hot  water.  There  were  instruments  of  bone, 
ivory,  and  metal,  for  scraping  the  skin,  with  a groove  in  the  edge, 
through  which  the  impurities  of  the  skin  might  run  off. 

On  the  north  front  of  the  thermae  was  a reservoir  of  cold  water 
large  enough  for  swimming,  called  by  Pliny  the  younger,  baptisterium. 
In  the  centre  was  a spacious  vestibiile,  and  on  each  side,  warm,  cold, 
and  vapor  baths,  with  apartments  for  cooling,  dressing,  and  refresh- 
ments. There  was  the  frigidarium,  a vaulted  room,  a cooling  room 
midway  between  the  warmer  and  the  open  air ; the  tepidarium,  with 
a temperature  midway  between  the  above  and  the  hot  bath ; and  the 
calidarium,  or  the  vapor  bath. 

Then  there  was  the  room  where  the  body  was  rubbed  over  with  a 
great  number  of  ointments  and  essences  of  the  most  precious  kinds ; 
and  another  in  which  it  was  sprinkled  over  with  powder ; and  also  a 
room  which  held  the  clothes,  in  which  the  bathers  undressed  and 
dressed  at  pleasure. 

All  these  apartments  were  double,  the  two  wings  being  appropri- 
ated to  the  sexes. 

Open  to  all.  — These  baths,  thus  numerous  and  magnificent,  were 
open  to  all  classes  of  the  people,  and  contributed  largely  to  the  gen- 
eral health  and  physical  endurance  for  which  the  Romans  were  con- 
spicuous. 

The  Bath  Neglected  under  the  Christian  System. — When  Jesus 
of  Nazareth  came  into  the  world,  he  found  man’s  nature  cultivated 
in  a most  defective  way.  The  moral  element  had  sunk  down  to  tlie 
lowest  place,  while  the  physical  had  risen  to  the  highest,  — just  the 
reverse  of  the  true  order  of  things.  This  Divine  Teacher  came,  not 
to  recommend  a neglect  of  the  body,  but  a new  cure  for  the  imper- 
ishable part.  Mankind  were  for  the  first  time  systematically  taught 
to  forgive  injuries.  Prostrate  liberty  and  degraded  woman  became 
the  wards  of  Christianity. 

Unfortunately,  under  the  new  order  of  things,  the  lower  element 
of  man,  which  had  been  exalted  and  worshipped,  was  cast  down  and 
abused.  What  the  Pagan  had  pampered,  the  Christian  persecuted. 


114 


HYGIENE. 


The  body,  which  had  been  bathed,  and  scrubbed,  and  anointed,  and 
perfumed,  was  thenceforward,  in  consequence  of  the  improper  inter- 
pretation of  certain  texts,  scourged,  and  fasted,  and  clothed  in  rags. 
Thousands  believed,  and  thousands  do  to  this  day,  that  to  torment 
the  body  is  to  please  God.  Under  this  feeling,  the  public  and  pri- 
vate baths  were  neglected , and  to  this  day  no  Chiistian  nation  has 
fully  appreciated  the  necessity  of  cleanliness,  and  of  sanitary  meas- 
ures for  the  maintenance  of  the  public  health.  To  a considerable 
extent,  the  body  is  still  under  disabilities ; still  the  subject  of  perse- 
cution ; and  where  this  is  not  the  case,  it  is  too  often  regarded  only 
as  a loose  outside  garment,  to  be  thrown  over  the  traveller  to  the 
celestial  city,  and  is  expected  to  be  well  soiled  with  mud  and  dust. 
The  teachings  of  the  Great  Master  will  by  and  by  cease  to  be  per- 
verted, and  will  be  applied  to  raise  up  man’s  body,  as  they  have 
raised  his  mental  and  moral  nature,  and  will  make  a well-developed 
and  harmonious  being. 

In  the  meantime,  it  is  the  duty  and  the  privilege  of  the  physician 
to  urge  a return,  not  to  the  magnificence  of  the  ancient  regimen  for 
training  the  body,  but  to  its  real  efficiency  in  a simpler  form. 

Cold  Bathing. — Water  applied  to  the  skin  at  a temperature  below 
76°  of  Farenheit,  is  called  a cold  bath.  If  applied  to  a person  with 
sufficient  constitutional  energy  to  bear  it,  it  is  a decided  and  very 
powerful  tonic.  By  this  is  meant  that  it  promotes  the  solidity,  com- 
pactness, and  strength  of  the  body. 

The  first  effect  of  the  application  of  cold  water  to  the  skin,  is  the 
sudden  contraction  of  all  its  vessels,  and  the  retreat  of  the  blood 
towards  the  internal  organs.  The  nervous  system,  feeling  the  shock, 
causes  the  heart  to  contract  with  more  energy,  and  throw  the  blood 
back  with  new  force  to  the  surface. 

This  rushing  of  the  blood  back  to  the  skin,  is  called  a reaction ; 
and  when  it  occurs  with  some  energy,  it  is  an  evidence  that  the  sys- 
tem is  in  a condition  to  be  much  benefited  by  the  cold  bath.  When 
this  does  not  take  place,  but  the  skin  looks  shrunken,  and  covered 
with  “ goose  flesh,”  and  a chilliness  is  felt  for  a longer  or  shorter  time 
after  bathing,  then  the  inference  should  he,  either  that  the  water  has 
been  used  too  profusely,  or  that  the  bather  has  too  little  reactionary 
power  for  this  form  of  the  bath.  The  latter  conclusion  must  not  be 
accepted  until  cold  water  has  been  tried  with  all  possible  guards,  — 
such  as  beginning  with  tepid  water,  and  gradually  lowering  the  tem- 
perature ; bathing  for  a time,  at  least,  in  a warm  room ; beginning 
the  practice  in  warm  weather ; and  applying  the  water  at  first  with  a 
sponge  out  of  which  most  of  it  has  been  pressed  by  the  hand.  With 
some  or  all  of  these  precautions,  most  persons  may  learn  to  use  the 
cold  bath.  It  is  always  to  be  followed  by  brisk  rubbing  with  a coarse 
towel  or  flesh-brush. 

The  Sponge  Bath. — A wet  sponge  is  the  simplest,  as  well  as  the 
best  mode  of  applying  water  to  the  surface  of  the  body.  With  per- 


HYGIENE. 


115 


sons  who  are  feeble,  a part  only  of  the  body  should  be  exposed  at  a 
time,  — which  part,  having  been  quickly  sponged  and  wiped  dry, 
should  be  covered,  and  another  part  exposed,  and  treated  in  a like 
manner.  In  this  way,  all  parts  of  the  body  may  successively  be  sub- 
jected to  the  bracing  influence  of  water  and  friction,  with  little  risk, 
even  to  the  most  delicate,  of  an  injurious  shock.  The  only  furniture 
required  for  carrying  out  this  simple  plan  of  bathing,  is  a sponge,  a 
basin,  and  a towel.  There  is  no  form  of  bathing  so  universally  appli- 
cable as  this,  or  so  generally  conducive  to  health. 

The  Shower  Bath  requires  a brief  notice.  The  shock  to  the  ner- 
vous system  produced  by  it  much  greater  than  that  from  sponging. 
Beside  the  sudden  application  of  coldness,  there  is  a concussion  of 
the  skin  by  the  fall  of  the  water.  This  form  of  the  bath  is  excellent 
for  those  who  are  strong  and  full  of  vitality,  but  is  fraught  with  some 
danger  for  the  feeble  and  delicate.  This,  however,  depends  on  the 
judgment  with  which  it  is  used.  In  the  form  of  a delicate  shower, 
and  with  tepid  water,  the  frailest  body  might  bear  its  shock. 

The  Warm  Bath; — A temperate  bath  ranges  from  75°  to  85°;  a 
tepid  bath,  from  85°  to  95° ; a warm  bath,  from  95°  to  98° ; a hot 
bath  from  98°  to  105°.  A warm  bath  is  of  the  same  temperature 
with  the  surface  of  the  body.  Of  course  it  produces  no  shock.  To 
those  who  are  past  the  meridian  of  life,  and  have  dry  skins,  and  begin 
to  be  emaciated,  the  warm  bath,  for  half  an  hour,  twice  a week,  is 
eminently  serviceable  in  retarding  the  advances  of  age. 

It  is  a mistake  to  suppose  the  warm  bath  is  enfeebling.  It  has  a 
soothing  and  tranquillizing  effect.  It  renders  the  pulse  a little 
slower,  and  the  breathing  more  even.  If  the  bath  be  above  98°,  it 
becomes  a hot  one,  and  the  pulse  is  quickened. 

The  temperature  of  the  warm  bath,  as  of  the  cold,  should  be  made 
to  range  up  and  down  according  to  the  vigor  of  the  frame,  and  the 
circulation  of  the  individual.  The  aged  and  the  infirm,  whose  hands 
and  feet  are  habitually  cold,  require  it  to  be  well  up  towards  the 
point  of  blood  heat.  The  pulse  should  not  be  made  to  beat  faster  by 
it,  nor  should  sensations  of  heat  or  fullness  be  induced  aboub  the 
temples  and  face. 

The  Vapor  Bath. — This  differs  from  the  warm  bath  in  being  ap- 
phed  to  the  interior  as  well  as  to  the  exterior  of  the  body.  The 
warmth  is  inhaled  into  the  air-tubes  at  the  same  time  that  it  envelops 
the  external  person.  The  first  sensation  of  the  vapor  bath  is  oppres- 
sion, and  causes  some  difficulty  of  breathing ; but  this  passes  off  as 
soon  as  the  perspiration  begins  to  flow.  From  the  steam-chamber, 
the  bather  should  step  into  a tepid  bath,  and  after  remaining  a short 
time  in  this,  wipe  himself  thoroughly  with  dry  towels. 

Cold  Affusion  immediately  after  either  the  warm  or  the  vapor  bath, 
is  excellent.  In  Russia  it  is  common,  after  the  vapor  bath,  to  pour 


116 


HYGIENE. 


upon  the  head  of  the  bather  a bucket  of  warm  water,  then  one  of 
tepid,  and  lastly  one  of  cold ; and  to  finish  with  giving  him  a good 
towelling.  It  is  even  said  that  the  natives  leave  the  steam  and  the 
hot  bath,  and  roll  themselves  in  the  snow. 

No  danger  need  be  feared  from  cold  affusion  when  the  skin  is  red 
and  excited  by  the  warm  bath,  provided  the  nervous  frame  is  not  in 
a depressed  condition.  If  the  body  is  chilled,  and  the  nerves  pros- 
trated by  disease  or  fatigue,  the  application  of  cold  water  to  the  skin 
may  do  great  mischief,  and  should  in  no  case  be  hazarded.  Cold 
water  applied  to  a hot  skin  cannot  do  harm ; to  a cold  skin,  it  can  do 
nothing  but  harm.  Hence,  the  cold  bath  may  be  used  with  advan- 
tage on  rising  in  the  morning,  while  the  body  is  warm.  Another  good 
time  is  at  ten  or  eleven  o’clock  in  the  forenoon,  when  the  nervous 
power  is  advancing  towards  its  height  for  the  day. 

Reaction  Necessary. — As  a means  for  promoting  cleanliness,  the 
importance  of  the  bath  can  hardly  be  overstated.  For  the  support 
and  improvement  of  health,  it  is  equally  important.  But  for  the  pro- 
motion of  the  latter,  one  prerequisite  is  essential,  — the  reaction  of 
the  skin. 

Various  means  are  resorted  to,  to  secure  this.  The  Hindoos  secure 
it  by  a kind  of  shampooing,  thus  described  by  a writer : “ One  of  the 
attendants  on  the  bath  extends  you  upon  a bench,  sprinkles  you  with 
warm  water,  and  presses  the  whole  body  in  an  admirable  manner. 
He  cracks  the  joints  of  the  fingers,  and  of  all  the  extremities.  He 
then  places  you  upon  the  stomach,  pinches  you  over  the  kidneys, 
seizes  you  by  the  shoulders,  and  cracks  the  spine  by  agitating  all  the 
vertebrae,  strikes  some  powerful  blows  over  the  fleshy  and  muscular 
parts,  then  rubs  the  body  with  a hair-glove  until  he  perspires,”  etc. 
“ This  process,”  says  the  writer,  “ continues  for  three-quarters  of  an 
hour,  after  which  a man  scarcely  knows  himself ; he  feels  like  a new 
being.”  Sir  John  Sinclair  speaks  thus  of  the  luxury  of  the  process: 
“ If  life  be  nothing  but  a brief  succession  of  our  ideas,  the  rapidity 
with  which  they  now  pass  over  the  mind  would  induce  one  to  believe 
that  in  the  few  short  minutes  he  has  spent  in  the  bath,  he  has  lived  a 
number  of  years.” 

The  Coarse  Towel,  the  horsehair  glove,  and  the  flesh-brush  are  the 
appliances  commonly  used  for  stimulating  the  skin,  and  causing  re- 
action. For  tender  skins,  the  towel  is  sufficiently  rough.  With  this 
the  bather  should  rub  himself,  unless  he  is  weak  and  the  exertion 
produces  palpitation.  The  muscular  exertion  necessary  for  this  will 
help  the  reaction. 

Restoration  of  the  Bath  desirable. — It  is  greatly  to  be  wished 
that  the  bath  might  be  restored  to  something  like  the  importance  it 
held  among  ancient  nations.  It  is  a luxury,  a means  of  health,  and 
a source  of  purity  both  of  body  and  of  mind ; for  the  morals  of  any 
people  will  rise  where  the  use  of  the  bath  is  regular  and  habitual. 


HYGIENE. 


117 


The  attempt  to  cure  all  diseases  by  what  is  called  the  “ water-cui’e,” 
has  a bit  of  fanaticism  about  it,  which  will  cure  itself  in  time.  But 
that  water,  used  judiciously  in  the  form  of  baths,  is  a potent  moral 
and  physical  renovator  of  the  race,  is  not  to  be  doubted ; and  this 
should  commend  it  to  all  sensible  people,  even  though  it  should  some- 
times be  abused  by  excess,  as  all  good  things  are. 

A people  with  clean  hands,  and  clean  bodies,  and  clean  health,  will 
very  naturally  come  to  like  clean  streets  and  clean  cities,  and  finally, 
clean  consciences.  A fondness  for  cleanliness  in  one  form,  almost  ne- 
cessarily runs  into  a like  fondness  for  it  in  other  forms,  until  the  pu- 
rifying desire  pervades  the  whole  nature,  moral  as  well  as  physical. 

Air  and  Ventilation. 

Wateh  and  air  are  fiuids.  Water  covers  two-thirds  the  surface  of 
the  globe,  having  a depth,  in  some  places,  of  five  miles  or  more.  Air 
covers  not  merely  the  remaining  third  of  the  earth,  but  the  water  as 
well.  It  embraces  the  entire  globe,  pressing  alike  upon  land  and 
water,  and  having  a depth  of  about  forty-five  miles.  This  is  a sea  of 
such  magnitude,  that  the  Atlantic  or  Pacific  shrinks  to  a very  small 
lake  in  the  comparison. 

Man  has  his  residence,  and  walks  about  at  the  bottom  of  this  ocean. 
He  has  no  means  of  navigating  it,  and,  therefore,  never  rises  to  its 
surface  ; but,  with  his  natural  eyes,  and  with  telescopes,  he  discovers 
objects  which  lie  millions  and  billions  of  miles  beyond  it,  and  even 
acquires  much  exact  and  useful  information  respecting  them. 

This  vast  ocean  of  air  we  call  an  atmosphere.,  from  two  Greek  words 
signifying  vapor,  and  a sphere, — it  being  an  immense  fluid-sphere,  or 
globe. 

Pressure  of  the  Atmosphere. — This  atmosphere  presses  upon  man 
and  upon  every  object  on  the  surface  of  the  earth,  with  a force  equal 
to  fifteen  pounds  to  every  square  inch ; and  as  a man  of  average  size 
has  a surface  of  about  2500  square  inches,  the  air  in  which  he  lives, 
presses  upon  him  with  a weight  of  eighteen  tons.  This  would  of 
course  crush  every  bone  in  his  body,  but  for  the  fluids  within  him 
which  establish  an  equilibrium,  and  leave  him  unoppressed. 

The  Philosophy  of  Breathing  cannot  be  fully  explained  in  the 
brief  space  allotted  to  this  subject;  it  is  enough  to  say,  that,  upon 
the  attempt  being  made  to  draw  in  the  breath,  the  muscles  of  the 
breast  draw  up  the  ribs,  the  diaphragm  or  midriff  at  the  same  time 
contracting, — the  whole  movement  being  such  as  to  create  a vacuum 
in  the  lungs.  The  air,  pressing  upon  every  part  of  the  surface,  as 
mentioned  above,  rushes  in  and  fills  the  vacuum.  The  lungs  being 
filled,  the  contraction  of  the  muscles  of  the  belly  causes  the  dia- 
phragm, which  has  sunk  down  towards  a plane,  to  rise  up  into  the 
form  of  an  umbrella,  and  squeeze  the  air  out  of  the  lungs. 


118 


BYGIEITE. 


This  is  about  all  that  need  to  be  said  of  the  method  of  getting  the 
air  into  and  out  of  the  lungs.  The  whole  process  is  under  the  con- 
trol of  that  part  of  the  nervous  system  called  the  medulla  oblongata, 
or  the  top  of  the  spinal  cord. 

Objects  of  Breathing. — There  are  at  least  three  objects  to  be  ac- 
complished by  breathing ; the  renewal  of  the  blood  and  the  taking  of 
impurities  out  of  it ; the  warming  of  the  body  ; and  the  finishing  up 
of  the  process  of  digestion,  and  the  change  of  chyle  into  nutritive 
blood. 

There  is  no  good  reason  for  attempting  here  to  explain  the  last  of 
these  objects.  To  give  any  idea  of  the  first  two,  it  is  necessary  to 
furnish  a very  brief  explanation  of  the  circulation  of  the  blood. 

The  heart  is  double.  There  are  in  fact  two  hearts,  a right  and  a 
left,  joined  together.  The  right  heart  receives  the  blood  from  the 
veins,  and  forces  it  up  into  the  lungs,  whence  it  is  brought  back  to 
the  left  heart,  and  by  this  is  driven  through  the  arteries  into  every 
part  of  the  body.  When  received  into  the  lungs,  the  blood  is  of  a 
dark  purple  color,  and  is  loaded  with  carbonic  acid  and  some  other 
impurities.  It  has  also  been  deprived,  during  its  circulation  through 
the  body,  of  most  of  its  oxygen.  The  small,  delicate  vessels  which 
convey  this  dark  and  impure  blood  through  the  lungs,  pass  directly 
over  the  air-cells ; and  at  this  moment  the  carbonic  acid  and  water 
pass  through  the  blood-vessels  and  air-cells,  and  are  borne  from  the 
body  on  the  outgoing  breath ; while  the  oxy- 
gen enters  the  blood  through  the  walls  of  the 
same  vessels ; and  this  exchange,  which  takes 
place  with  every  breath,  alters  the  blood  from 
a dark  purple  to  a scarlet  red.  Fig.  71 
shows  at  1,  a bronchial  tube  divided  into  three 
branches ; 2,  2,  2,  are  air-cells ; 3,  branches  of 
the  pulmonary  artery  winding  around  the  air- 
cells  with  the  dark  blood  to  be  reddened. 

That  carbonic  acid  and  water  are  borne  out  of  the  lungs  with  every 
breath,  may  be  easily  proved.  If  we  breathe  into  lime-water,  it  will 
become  white.  This  is  owing  to  the  carbonic  acid  in  the  breath  unit- 
ing with  the  lime,  and  producing  carbonate  of  lime.  Then,  if  we 
breathe  upon  a piece  of  glass,  it  becomes  wet,  showing  that  there  is 
watery  vapor  in  the  breath.  That  the  blood  receives  oxygen  from 
the  air  we  breathe  is  proved  by  the  fact  that  the  ingoing  breath  has 
one-fourth  more  oxygen  in  it  than  the  outgoing. 

The  lungs,  then,  take  out  of  all  the  air  we  breathe,  one-fourth  of 
its  oxygen.  If  we  breathe  it  over  a second,  a third,  and  a fourth 
time,  it  not  only  has  less  oxygen  each  time,  and  is  less  useful  for  the 
purposes  of  respiration,  but  it  becomes  positively  hurtful  by  rea- 
son of  the  poisonous  carbonic  acid  wliich,  at  every  outgoing  breath, 
it  carries  with  it  from  the  lungs. 

Effect  of  -Sleeping  in  a Small  Room. — Now,  consider  the  effect  of 


Fig.  71. 


HYGIENE. 


119 


sleeping  in  a small  room,  seven  feet  by  nine,  not  furnished  with  the 
means  of  ventilation.  A pair  of  lungs,  of  ordinary  size,  take  in,  at 
each  breath,  about  a pint  of  air.  Out  of  this  air  one-fourth  of  its 
oxygen  is  extracted ; and  when  it  is  returned  from  the  lungs,  there 
comes  along  with  it  about  eight  or  nine  per  cent  of  carbonic  acid. 
As  it  is  not  safe  to  breathe  air  containing  more  than  three  or  four 
per  cent  of  this  gas,  the  pint  which  the  lungs  take  in  and  throw  out 
at  each  breath  is  not  only  spoiled,  but  it  spoils  something  more  than 
another  pint  with  which  it  mingles ; and  as  the  breath  is  drawn  in 
and  thrown  out  about  eighteen  times  per  minute,  not  less  than  four 
cubic  feet  of  air  is  spoiled  in  that  time  by  one  pair  of  lungs.  This  is 
two  hundred  and  forty  feet  an  hour ; and  in  eight  hours,  the  usual 
time  spent  in  the  sleeping  room,  it  amounts  to  one  thousand  nine 
hundred  and  twenty  cubic  feet.  During  the  hours  of  sleep,  therefore, 
one  pair  of  lungs  so  spoil  one  thousand  nine  hundred  and  twenty 
cubic  feet  of  air  that  it  is  positively  dangerous  to  breathe  it. 

In  a room  seven  feet  by  ten,  and  eight  feet  high,  there  are  five 
hundred  and  sixty  cubic  feet  of  air,  a little  more  than  one-quarter 
the  amount  spoiled  by  one  pair  of  lungs  during  sleeping  hours.  In 
a room  of  this  size,  there  is  not  air  enough  to  last  one  person  three 
hours  ; and  yet  two  persons  often  remain  in  such  rooms  eight  or  nine 
hours. 

Why  then  do  they  not  perish  ? Simply  because  no  room  is  entirely 
air-tight.  Fortunately,  all  our  rooms  are  so  made  that  some  foul  air 
will  get  out,  and  a little  that  is  pure  will  find  its  way  in.  Were  it 
not  so,  no  man  who  closed  the  door  behind  him,’ for  the  night,  in  a small 
bed-room,  would  ever  see  a return  of  day. 

Suppose  fifty  children  are  confined  in  an  unventilated  school-room, 
twenty  feet  by  thirty,  and  ten  feet  high.  These  children  will  spoil 
about  one  hundred  and  fifty  feet  of  air  in  one  minute,  or  nine  thou- 
sand feet  per  hour,  or  twenty-seven  thousand  feet  in  three  hours,  — a 
usual  half-day’s  session.  But  the  room  holds  only  six  thousand  cubic 
feet  of  air, — the  whole  of  which  these  children  would  spoil  in  forty 
minutes. 

These  simple  facts  show  the  absolute  necessity  of  ventilation.  Yet 
how  poorly  it  is  provided  for  in  our  sleeping  rooms,  our  sitting  rooms, 
our  school  houses,  our  churches,  our  court  houses,  our  halls  of  legis- 
lation, and  even  in  our  anatomical  and  medical  lecture-rooms  ! 

In  sick=rooms,  ventilation  should  .receive  special  attention. — 

Every  disease  is  aggravated  by  the  breathing  of  bad  air.  Yet  it  is 
common  to  close  all  the  doors  and  windows  of  rooms  where  sick  per- 
sons are  confined,  lest  the  patients  should  take  cold.  This  is  a bad 
practice.  The  sick  should  have  plenty  of  fresh  air.  Their  comfort 
is  promoted  by  it,  and  their  recovery  hastened. 

It  is  strange  that  human  beings  should  be  afraid  of  pure  air.  It 
is  their  friend  and  not  their  enemy.  Impure  air  only  should  be 
shunned. 


120 


HYGIENE. 


The  supply  of  good  air  ample. — There  is  no  necessity  for  breath- 
ing air  which  has  lost  a part  of  its  oxygen,  and  acquired  a portion  of 
carbonic  acid.  The  supply  of  good  air  is  ample.  An  ocean  of  it 
forty-five  miles  deep,  covering  the  whole  globe,  seems  a pretty  plain 
intimation  that  it  is  not  to  be  sparingly  used.  When  men  retire 
within  their  dwellings,  and  attempt  to  shut  out  this  great  sea  of  air, 
they  show  about  as  much  wisdom  as  would  be  exhibited  by  fishes 
which  should  build  water-tight  huts  around  themselves  at  the  bottom 
of  the  ocean,  and  swim  about  continually  in  the  unchanged  water 
within.  Fishes  can  only  live  in  glass  globes  when  the  water  is 
changed  every  day ; and  if  the  water  be  changed  half  a dozen  times 
a day,  they  cannot  be  as  healthy  as  when  swimming  in  the  great 
ocean. 


Cultivating  Trees. — In  most  of  our  cities  there  is  almost  a crimi- 
nal neglect  of  the  cultivation  of  trees ; yet  they  add  greatly  to  the 
health,  and  prolong  the  lives  of  the  citizens. 

The  leaves  of  a tree  are  the  lungs  with  which  it  breathes  ; but  in- 
stead of  extracting  oxygen  from  the  air,  and  giving  back  carbonic 
acid,  like  man,  it  takes  only  the  poisonous  carbonic  acid,  and  gives 
back  oxygen. 

Were  there  no  animals  on  the  globe,  the  vegetables  would  con- 
sume all  the  carbonic  acid,  and  die  for  want  of  breathing  maf^erial ; 
on  the  other  hand,  were  there  no  trees  or  other  vegetables,  the  ani- 
mals would  in  time  so  far  exhaust  the  oxygen  as  to  perish  for  lack 
of  it.  The  two  together  keep  the  air  healthy  for  each. 

The  relation  of  plants  and  animals,  in  all  that  relates  to  their 
peculiar  a,ctions  and  effects,  is  a complete  antagonism.  Their  move- 
ments are  in  contrary  directions,  and  by  hostile  forces.  Their  oppos- 
ing actions  may  be  illustrated  thus  : — 


The  vegetable  pkoduces  the  non- 
nitrogenized  substances,  sugar,  starch, 
and  gum. 

The  vegetable  decomposes  carbonic 
acid,  water,  and  ammoniacal  salts. 

The  vegetable  disengages  oxygen. 

The  vegetable  absokbs  heat  and 
electricity. 

The  vegetable  is  a de-oxidizeb. 

The  vegetable  is  stationaey. 


The  animal  consumes  the  non-ni- 
trogenized  substances,  sugar,  starch, 
and  gum. 

The  animal  produces  carbonic  acid, 
water,  and  ammoniacal  salts. 

The  animal  absorbs  oxygen. 

The  animal  produces  heat  and 
electricity. 

The  animal  is  an  oxidizer. 

The  animal  is  locomotive. 


We  learn  from  the  facts  of  Geology  that  the  time  was  in  the  his- 
tory of  our  globe,  when  lunged  animals  could  not  breathe  its  atmos- 
phere; it  was  too  much  loaded  with  carbonic  acid.  The  trees  then 
grew  with  a rapidity  almost  inconceivable,  decomposing  the  poison- 
ous gas,  taking  to  themselves  the  carbon  and  setting  the  oxygen 
free,  and  lifting  up  their  brawny  arms  to  heaven  in  acts  of  thankful- 
ness for  the  great  feast. 

At  length  the  noxious  gas  was  exhausted;  and  then,  pale  and 
sickly,  they  feebly  held  up  their  hands  for  help;  and  God  sent  num- 
berless tribes  of  warm-blooded  animals,  full  of  life  and  energy,  that 


HTGIEKE. 


121 


«ported  in  the  exhilarating  air,  and  destroyed  vast  forests,  thereby 
reproducing  carbonic  acid. 

These  simple  facts  should  teach  man  the  sanitary  importance  of 
trees  and  bushes ; and  wherever  he  has  a rod,  I had  almost  said  a 
foot  of  ground  to  spare,  a tree  should  be  planted  and  carefully 
nursed.  This  is  particularly  necessary  in  large  cities.  Every  narrow 
street  in  a city  should  be  lined  with  trees.  For  their  absence,  thou- 
sands of  men,  women,  and  children  have  died  sooner  than  they 
otherwise  would.  We  want  them  stretching  up  their  arms  to  all 
our  windows  to  give  us  oxygen,  and  to  take  to  themselves  the  car- 
bonic acid  we  exhale. 

Tight  Dresses.  — The  health  may  be  injured  by  not  breathing  air 
enough,  as  well  as  by  inhaling  that  which  is  impure.  It  is  therefore 
improper  to  compress  the  lungs  by  wearing  tight  dresses.  If  the 
ribs  are  held  down  by  the  dress,  but  little  air  can  get  into  the  lungs, 
and  only  a small  amount  of  carbonic  acid  can  be  carried  out.  In 
this  event,  the  health  is  injured  in  two  ways : the  blood  is  not  vital- 
ized by  oxygen  received,  and  it  is  poisoned  by  carbonic  acid  retained. 

Tight  lacing  has  in  a measure  gone  out  of  fashion  ; yet  too  much 
of  it  for  the  best  development  of  female  health  is  yet  retained.  As 
a knowledge  of  physiology  and  the  laws  of  life,  and  a better  judg- 
ment of  the  true  symmetry  of  the  female  form  prevail,  this  barbar- 
ous custom  will  pass  out  of  use,  and  the  substantial  health  and 
real  beauty  of  the  American  woman  will  together  rise  to  a higher 
standard. 

Fill  the  Lungs  well.  — Persons  who  take  but  little  exercise  are 
apt  to  acquire  the  habit  of  drawing  the  air  very  little  into  the  lower 
part  of  the  lungs.  This  should  be  counteracted  by  taking  long  and 
full  inspirations  for  a short  time,  every  day,  while  in  the  open  air. 
This  practice  would  get  the  lungs  in  the  habit  of  opening  to  the  air 
quite  down  to  their  base,  and  would  make  the  breathing  much  more 
natural  as  well  as  effectual  at  all  times.  In  the  case  of  young  per- 
sons, it  would  enlarge  the  capacity  of  the  chest,  and  add  to  the  brief 
years  of  life.  Parents  should  see  to  it  that  their  children  spend 
from  ten  to  twenty-five  minutes  every  morning  inflating  their  lungs 
with  pure  air. 

Travell  ing. 

It  is  true  that  many  persons  who  dwell  in  one  spot,  and  hardly 
move  from  it  all  their  lives,  live  to  old  age.  Yet  change  of  location 
for  a short  time,  or  permanently,  does  promote  health,  and  protract 
life.  The  mind  tires  of  contemplating  one  set  of  objects  for  a great 
length  of  time ; and  in  the  absence  of  all  stimulation,  it  sinks  into 
apathy,  and  imparts  no  energy  to  the  body.  The  physical  frame, 
partaking  of  the  ennui  of  the  mind,  droops.  This  is  doubly  true 
when  one  is  suffering  from  illness. 


122 


HYGIENE. 


Travelling  is  eminently  fitted  to  draw  the  thoughts  of  the  nervous 
and  feeble  from  themselves,  and  to  turn  them  with  interest  to  out- 
ward objects.  This  is  of  great  importance.  It  is  better  than  stimu- 
lants and  tonics. 

The  nervous  system  has  great  power  over  the  health;  and  the 
pleasurable  sensations,  excited  by  visiting  new  places  and  scenes, 
and  conveyed  to  the  mind  through  the  nerves,  often  awaken  in  the 
constitution  energies  which  are  essential  to  recovery. 

Travelling  places  a man  in  entirely  new  circumstances.  It  sur- 
rounds him  with  novelties,  every  one  of  which  makes  a demand  upon 
his  attention.  It  breaks  up  his  old  trains  of  thought,  which  have 
been  monotonous  so  long  that  they  have  grown  oppressive.  It 
causes  the  world  to  touch  him  at  a thousand  new  points,  and  sur- 
prises him  every  day,  perhaps  every  hour,  with  a view  of  the  false 
relations  he  has  sustained  to  it.  It  opens  to  liim  new  depth?  in  his 
own  nature,  and  causes  him  to  wonder  that  they  never  attracted  his 
attention  before.  It  opens  to  him  one  door  after  another,  leading 
him  into  new  apartments  of  knowledge ; and  as  the  world  grows,  he 
finds  himself  growing  with  it,  until  his  whole  nature  dilates  and 
beats  with  new  life. 

Means  of  Travelling  Increased.  — The  last  twenty-five  years 
have  greatly  increased  the  facilities  for  travelling.  Many  of  the 
sick  may  now  seek  health  in  distant  lands,  who,  had  their  circum- 
stances been  similar  twenty  years  ago,  would  have  been  compelled 
to  pine  at  home.  The  railroads  give  an  easy  journey  to  thousands 
with  the  comforts  of  the  parlor  cars. 

One  thing  more  wanted.  — But  one  thing  is  wanted  to  bring  the 
means  of  travelling,  for  the  sick,  very  nearly  to  perfection ; it  is  a 
method  of  propelling  carriages  upon  common  roads,  by  some  cheap 
power,  which  can  never  be  exhausted,  and  which  shall  be  easily  man- 
aged by  the  traveller  or  his  companion.  This  is  a prominent  want 
of  the  present  hour ; a giant  discovery,  which,  at  a single  stride, 
would  carry  the  world  forward  a hundred  years,  and  which,  we  may 
hope,  is  in  the  womb  of  the  near  future.  The  power,  it  is  believed, 
will  be  electromagnetism.  The  mode  of  applying  it,  when  discovered, 
will  be  simple,  yet  wonderful ; and  the  results  to  the  sick,  beneficent 
beyond  expression.  The  human  mind  cannot  conceive  the  advan- 
tages which  invalids  would  derive  from  such  a mode  of  conveyance. 
Journeys  might  be  long  or  short;  might  be  made  with  any  rate  of 
speed  which  the  strength  permitted.  The  morning  or  afternoon 
stages  might  be  discontinued  when  fatigue  demanded,  and  resumed 
at  pleasure.  Over  uninviting  regions  the  traveller  might  glide 
swiftly,  and  linger  where  Nature  spreads  her  feasts  for  the  mind. 

The  best  Seasons  for  Travelling  are  spring  and  autumn.  Win- 
ter is  too  cold.  A pleasurable  excursion  may  sometimes  be  made  in 
summer,  but  in  general  the  season  is  too  hot  for  comfort.  In  chang- 


HYGIENE.  123 

ing  climate,  food,  water,  etc.,  in  the  sultry  season,  there  is  danger  of 
contracting  very  troublesome  bowel  complaints. 

Means  of  Travelling  for  the  Poor.  — There  is  one  painful  thought 
connected  with  travelling  as  a means  of  health,  — it  cannot  be  en- 
joyed by  the  poor.  When  sick  they  generally  have  the  careful 
attention  of  humane  physicians ; they  receive  from  kind  neighbors 
little  delicacies  of  food  and  drink ; they  are  watched  with  by  night, 
and  visited  by  day ; but  though  suffering  from  the  hard  routine  of 
a laborious  life,  and  needing  diversion  and  recreation  more  than  all 
else,  they  cannot  travel.  They  have  not  the  means,  and  nobody 
thinks  of  supplying  them  for  such  a purpose. 

This  is  a channel  into  which  charity  ought  to  pour  some  of  its 
benevolent  streams.  In  large  cities  there  is  a class  of  poor  females 
who  sit  in  their  small  rooms  and  ply  the  needle  diligently  through 
the  whole  year,  and  who  run  down  every  summer  very  near  to  con- 
finement in  bed.  Two  or  three  weeks,  in  the  hot  season,  spent  in 
travelling  in  the  mountains  and  elsewhere,  would  bring  back  the 
color  to  the  pale  cheeks  of  such  persons,  and  save  them  many  years 
both  from  the  grave  and  from  the  almshouse.  No  millionaire  could 
make  a better  use  of  property  than  to  set  it  apart,  at  his  death,  for 
the  specific  purpose  of  enabling  the  poor  to  travel.  And  if  this 
suggestion  should  induce  one  rich  man  to  consecrate  his  wealth  to 
the  Godlike  work  of  bestowing  health,  happiness,  and  intelligence 
upon  the  poor,  the  great  labor  of  preparing  this  book  will  not  have 
been  endured  in  vain. 


Amusements. 

That  which  engages  the  mind,  and  at  the  same  time  impresses  it 
with  pleasurable  sensations,  is  a sufficiently  accurate  definition  of 
amusement.  Whatever  occupies  the  thoughts  and  senses  in  an 
agreeable  way,  and  employs  them  with  some  degree  of  intensity, 
comes  under  the  same  head. 

This  broad  and  general  definition  allows  us  to  disregard  our  daily 
employments  as  amusements  when  they  engage  our  deep  attention 
and  at  the  same  time  give  us  pleasure. 

The  term  “ amusements,”  however,  in  the  more  popular  sense,  is 
restricted  to  those  sports,  games,  plays,  exhibitions,  entertainments, 
etc.,  which  involve  a suspension  of  our  daily  labors,  and  are  properly 
called  diversions. 

When  nature  is  tired  and  worn  with  those  severe  and  exhausting 
toils  by  which  we  earn  our  bread,  amusements  turn  us  aside,  divert 
us,  engage  other  powers,  and  allow  our  tired  faculties  to  rest.  They 
are,  therefore,  of  very  great  importance.  Even  the  most  trifling 
amusements  may  have  the  highest  value.  Their  very  nature  and 
object  imply  that  they  will  be  valuable  just  in  proportion  as  they 
divert  and  rest  us.  And  just  in  proportion  as  they  do  these  things, 
they  give  us  health. 


124 


HYGIENE. 


One  other  thing  amusements  do  for  us,  which  must  not  be  forgot- 
ten ; they  preserve  in  us,  in  middle  life,  and  even  in  old  age,  the 
warm  simplicity  of  childhood.  They  keep  us  young  in  our  disposi- 
tions and  feelings.  They  keep  us  in  harmony  with  nature,  and  con- 
sequently artless  and  truthful.  They  prevent  the  formalities  of  con- 
ventional life  from  stiffening  us  into  cold  and  repulsive  hypocrites. 

Selection  of  Amusements.  — Of  course  the  same  amusements  are 
not  adapted  to  all  persons.  The  farmer  who  has  worked  his  muscles 
all  day,  would  not  be  benefited  by  a game  of  ball  in  the  evening ; 
yet  there  are  few  games  more  suitable  for  the  student  who  has  bent 
for  many  hours  over  his  books.  Care  should  always  be  taken,  there- 
fore, that  amusements  or  sports  do  not  bear  upon  those  limbs  or 
faculties  which  are  wearied  by  work. 

Amusements  improve  various  faculties.  — To  one  who  has  a 

taste  for  art,  who  is  fond  of  works  of  genius  and  poetry,  theatrical 
entertainments  will  always  be  agreeable,  and  a source  of  gratification 
and  health.  I know  these  exhibitions  are  objected  to  by  many  as 
immoral  and  hurtful,  but  more,  I think,  from  habit  and  fashion,  than 
upon  any  solid  grounds  of  reason  or  religion.  They  certainly  appeal 
to  a high  order  of  faculties  in  the  human  mind ; and  to  those  who 
are  fitted  to  receive  them,  teach  lessons  of  great  moment.  Even  the 
lower  exhibitions  of  comedy,  though  not  particularly  improving  to 
the  mind,  are  yet,  from  their  power  to  provoke  Imighter,  among  the 
most  powerful  up-builders  of  health.  ■ , 

The  Games  of  Whist,  Euchre,  etc.,  engage  the  minds  of  the  play- 
ers in  a sort  of  mental  contest,  which  is  exciting,  agreeable,  and  . 
health-imparting.  These  games  make  us  skilful  in  calculating 
chances,  and  judging  how  men  ought  to  act  under  certain  contin- 
gencies. They  make  us  sharp  to  detect  and  turn  aside  the  unseen 
forces,  which  tend  to  oppose  and  destroy  our  success  in  life. 

I hardly  need  to  say  that  money  or  rather  property  should  never 
be  staked  upon  a game  of  cards,  or  upon  any  other  game.  Gambling 
is  one  of  the  meanest  as  well  as  most  destructive  things  in  which  men 
can  engage.  It  raises  the  healthful  excitement  of  these  innocent 
amusements,  — innocent  when  properly  pursued,  — into  raging  pas- 
sions, which,  when  defeat  comes,  as  come  it  will,  sink  into  remorse 
and  bitterness  as  terrible  as  the  mind  can  conceive.  I warn  young 
men,  as  they  would  escape  the  pangs  of  a hell  on  earth,  and  the  loss 
of  character,  happiness,  and  probably  health  for  life,  to  avoid  any 
such  abuse  of  cards. 

Chess,  Chequers,  etc.,  appeal  likewise  to  the  fondness  of  competi- 
tion, which  is  common  to  all  men.  But  they  cultivate  in  us  a little 
more  of  the  mathematical  element.  As  they  require  very  close  appli- 
cation of  the  mind,  they  are  not  suitable  for  persons  of  sedentary  em- 
ployments, or  whose  daily  avocations  require  a constant  use  of  the 


HYGIENE. 


125 


mind.  Such  persons  should  choose  lighter  and  more  active  amuse- 
ments. 

Lighter  Amusements. — Beside  these  higher  amusements,  there 
are  a great  number  of  lighter  and  more  childish  ones,  which  should 
not  be  overlooked. 

Some  of  these  are  merely  physical,  involving  a trial  of  strength, 
fleetness,  action,  etc.,  as  the  games  of  ball,  cricket,  etc.  Others  are 
domestic  in  their  nature,  involving  mirth,  and  various  other  of  the 
lighter  excitements,  as  blind-man’s  buff,  puss  in  the  corner,  hole  in  the 
wall,  fox  and  geese,  hunt  the  slipper,  hurly-burly,  roll  the  platter,  etc. 

In  fashionable  American  households,  these  simple  domestic  plays 
have  in  a great  measure  gone  out  of  use, — being  deemed  vulgar,  and 
below  the  dignity  of  ladies  and  gentlemen.  I am  sorry  to  say  this ; 
for  the  vulgarity,  in  my  judgment,  is  in  those  who  reject  them,  and 
not  in  the  play. 

The  officer  of  our  navy,  whose  visit  to  the  mansion  of  Lord  Hard- 
wick I have  spoken  of  on  page  93,  reports  that  on  the  evening  of  one 
of  his  visits,  the  play  of  blind-man’s  buff  was  engaged  in  by  the  whole 
party ; and  that  his  Lordship  in  attempting  to  make  a short  turn  dur- 
ing the  play  fell  upon  his  back,  when  one  of  his  daughters,  who  was 
blinded,  caught  him  by  the  heels,  and  being  assisted  by  others,  drew 
him  feet-foremost  half  the  length  of  the  hall,  amid  the  shouts  of  the 
whole  party.  Th;s  would  have  been  deemed  very  vulgar  by  fashion- 
able people  in  this  country.  But  to  me,  who  am  no  believer  in  any 
nobility  which  Lord  Hardwick  can  receive  from  kings  or  queens,  this 
simple  narrative  raised  him  at  once  to  a peerage  in  nature’s  realm. 
Without  doubt,  he  is  one  of  nature’s  noblemen.  A man  in  his  sta- 
tion, and  with  his  wealth  and  temptations  to  snobbery,  who  can  pre- 
serve such  simplicity  of  character,  must  have  a warm  as  well  as  a 
noble  heart  in  his  breast. 

Value  of  Domestic  Amusements. — I remark  here  that,  in  all  our 
amusements,  we  should,  as  far  as  possible,  seek  those  of  a domestic 
character.  They  are  more  simple  and  childlike  in  their  nature,  and 
preserve  in  us,  even  to  old  age,  the  freshness  of  feeling,  and  truthful 
simplicity,  which  spread  so  beautiful  a greenness  over  the  autumn  of 
life. 

Simple  domestic  amusements,  too,  are  always  gotten  up  on  a cheap 
scale;  they  do  not  encourage  costly  extravagance,  and  can  be  in- 
dulged in  by  the  poor  as  well  as  the  rich. 

But  more,  and  better  than  all,  they  keep  young  men  and  old  men, 
and  young  women  and  old  women,  at  home,  by  making  the  domestic 
circle  the  centre  of  attraction.  They  draw  the  seekers  of  pleasure 
around  the  hearth-stone,  instead  of  outward  in  the  world.  They  in- 
cline young  and  old  to  look  to  the  family  circle  as  the  centre  of  the 
most  pure,  because  the  most  simple  and  natural,  enjoyments.  They 
teach  us  to  look  to  home  as  the  centre  of  life,  and  to  all  outside  as 
only  its  appendages. 


126 


HYGIENE. 


It  has  been  said  that  homes  are  found  only  in  England ; that  in 
other  countries,  life  wanders,  houseless  and  shelterless,  abroad,  seek- 
ing happiness,  it  knows  not  where,  while  in  England  it  nestles  warmly 
in  the  bosom  of  home.  To  whatever  extent  this  is  true, — and  I be- 
lieve there  is  truth  in  it, — it  is  owing  to  the  simple  household  amuse- 
ments of  England. 

An  American  Want. — One  of  the  great  wants  of  this  country  is  a 
more  liberal  provision  for  amusements.  We  attach  here  too  much 
value  to  wealth ; and  we  pursue  it  with  an  intensity  altogether  in- 
compatible with  health.  W e cannot  take  time  for  recreation  because 
we  are  in  so  great  a hurry  to  be  rich. 

If  we  would  save  ourselves  from  a total  wreck  of  health,  we  must 
take  broader  and  better  views  of  life.  We  must  value  it  for  its  solid 
comforts,  rather  than  for  its  glitter  and  show. 

Contrary  to  the  general  belief,  insanity  is  very  prevalent  among 
seamen  and  farmers.  The  former  lead  a life  of  dreary  solitude  upon 
the  ocean ; the  latter,  one,  if  not  of  equal,  certainly  of  very  objection- 
able solitude  upon  the  land.  The  sailor  who  does  business  upon  the 
great  sea  should  provide  himself  with  great  numbers  of  games  to 
amuse  him  in  his  wanderings.  The  farmers  of  our  land  should  cul- 
tivate more  of  the  sociabilities  of  life.  Let  them  meet  together  in 
the  fine  summer  evenings,  like  the  peasants  of  France,  and  dance 
upon  the  green  lawns  before  their  cottages.  They  will  till  their  lands 
more  cheerfully  for  it ; enjoy  better  spirits  and  health ; and  live  to 
greater  age. 

Completeness  of  Life.  — Amusements  are  necessary  in  order  to 
give  a completeness  to  life.  The  faculties  of  the  human  mind  are 
numerous.  It  is  only  when  they  are  all  exercised,  in  their  due  pro- 
portion, that  there  is  a harmonious  beauty  in  our  lives.  The  cus- 
toms of  society  twist  us  all  out  of  shape,  — perverting  us  mentally, 
morally,  and  physically,  and  robbing  us  of  every  manly  and  health- 
ful quality.  Getting  out  of  the  ruts  of  fashionable  life,  we  must 
come  back  to  the  simple  paths  of  nature. 

I would  strongly  impress  upon  parents,  teachers,  and  guardians, 
the  importance  of  studying  well  the  various  temperaments,  physical 
and  mental  peculiarities  of  their  children,  in  order  to  judge  wisely 
of  the  kind  and  amount  of  recreation  required  by  them. 

Instance  : a pale,  delicate  child  of  ten  to  twelve  or  fourteen  years, 
with  clear  complexion,  flaxen  hair,  blue  eyes,  slender  frame,  and  a 
nervous,  sensitive  organization,  with  strong  mental  cast,  requires 
much  more  recreation  and  out-door  exercise  than  a full-blooded, 
robust  child  of  that  age ; a fact  not  at  present  duly  considered,  as  a 
general  thing. 


TEMPERAMENTS 

AND 

CONSTITUTION  of  the  BODY 

AND 

SYMPTOMS  of  DISEASES 


% 


It  is  necessary  that  the  reader  should  understand  the  temperament 
and  constitution  of  the  body  and  symptoms  of  diseases 
that  they  may  intellig^ently  diagnose 
the  case. 


TEMPEEAMENTS,  CONSTITUTION,  AND 

SYMPTOMS. 


Man  has  thinking^  warming,  nourishing,  and  moving  powers.  For 
the  performance  of  each  of  these  great  functions,  he  has  organs  of 
the  best  possible  construction. 

For  Thinking,  he  has  a hrain.  If  this  be  large  in  proportion  to  his 
other  organs,  it  gives  a character,  a cast,  a peculiarity  to  his  whole 
organization.  Everything  about  him  is  subordinate  to  his  brain. 
We  recognize  him,  at  once,  as  a thinking  and  feeling  being.  He 
has  an  intellectual  look.  There  is  a delicacy,  a refinement,  a sensi- 
tiveness, a studious  habit,  an  air  of  thoughtfulness  about  him,  which 
determine  his  traits,  his  tone,  his  temper,  his  whole  character.  Hence 
it  is  proper  to  say  he  has  a cephalic  or  thinking  temperament. 

The  Lungs  and  Heart,  devoted  to  renewing  and  circulating  the 
blood,  are  placed  in  the  chest  or  thorax.  If  these  he  large  in  man  in 
proportion  to  other  organs,  he  is  characterized  by  great  activity  of  cir- 
culation, by  a large  supply  of  red  blood,  and  by  the  general  indica- 
tions of  a full,  warm,  and  bounding  life.  This  activity  gives  him 
his  tone  and  temper,  and  shows  that  his  is  the  thoracic  or  calorific 
temperament. 

In  the  Great  Cavity  of  the  Abdomen  is  done  the  work  of  receiv- 
ing, digesting,  and  disposing  of  the  materials  which  nourish  the  body. 
If  the  organs  which  do  this  work  be  large  in  proportion  to  others,  the 
body  is  fed  to  repletion,  and  the  whole  organization  speaks  of  the 
table.  The  habit,  the  look,  the  temper,  are  all  sluggish.  This  is  the 
abdominal  or  alimentary  temperament. 

The  Bones  and  Muscles  are  instruments  by  which  the  movements 
of  the  body  are  performed.  If  these  be  the  largest,  in  proportion,  of 
any  in  the  body,  then  the  locomotive  powers  are  in  higher  perfection 
than  any  others.  There  is  largeness  of  person,  energy  of  movement, 
and  greatness  of  endurance.  The  whole  cast  of  the  person  partakes 
of  the  strength  and  coarseness  of  bone  and  muscle.  This  is  the 
muscular  or  locomotive  temperament. 

This  gives  us  four  temperaments,  as  follows : — 

I.  The  Cephalic  Temperament,  denoted  by  large  brain,  activity  of 
mind,  and  general  delicacy  of  organization. 

128 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 


129 


II.  The  Thoracic  Temperament,  indicated  by  a large  chest,  force 
of  circulation,  redness  of  skin,  great  activity,  warmth  of  temper, 
and  fulness  of  life. 

III.  The  Abdominal  Temperament,  denoted  by  a large  develop- 
ment of  the  stomach,  liver,  bowels,  and  lymphatics ; by  ,a  fulness  of 
belly,  fondness  of  high  living,  and  a disposition  to  float  sluggishly 
upon  the  current  of  the  world,  rather  than  to  struggle  against  it. 

IV.  The  Muscular  Temperament,  indicated  by  largeness  of  frame 
and  limbs,  coarseness  of  structure,  and  great  power  of  locomotion 
and  endurance. 

There  are  some  reasons  for  reckoning  but  three  temperaments  in- 
stead of  four,  by  reducing  the  thoracic  and  abdominal  to  one,  after 
the  manner  of  the  phrenological  Fowlers,  — especially  as  the  organs 
in  the  chest,  and  their  appendages,  take  an  important  part  in  the 
process  of  nutrition.  But  as  the  heart  and  lungs  are  placed  in  one 
cavity,  and  the  stomach,  liver,  etc.,  in  another,  and  as  one  set  of 
these  organs  may  be  largely  developed,  and  the  other  defectively,  I 
have  thought  it  most  convenient,  on  the  whole,  and  quite  as  philo- 
sophical, to  retain  the  four  temperaments. 

These  temperaments  seldom  or  never  appear  single  and  pure. 
They  mix  and  cross  with  each  other  in  all  possible  ways. 


Medication  and  Temperaments. 

The  object  of  speaking  of  temperaments  in  this  work  is  to  make 
the  reader  acquainted  with  the  principles  upon  which  remedies  are 
to  be  adapted  to  their  development.  The  philosophical-minded  phy- 
sician will,  in  prescribing,  always  keep  the  temperament  in  view. 

Persons  of  a Cephalic  Temperament  cannot  bear  powerful  medi- 
cines, — particularly  drastic  purges.  Their  fine,  delicate  and  sensi- 
tive organizations  would  be  torn  all  to  pieces  by  doses  which  would 
hardly  be  sufficient  in  a fully-developed  muscular  temperament. 
This  should  always  be  borne  in  mind  in  prescribing  for  persons  of  a 
large  brain  and  delicate  organization. 

In  this  temperament,  too,  fevers,  instead  of  running  a high  and 
fiery  course,  take  the  low  typhoid  type,  the  patient  becoming  pale, 
and  showing  a constant  tendency  to  sink.  Such  patients  would  be 
killed  by  purging,  leeching,  cupping,  sweating,  and  starving.  They 
want  tonics,  stimulants,  and  every  kind  of  support  which  the  case 
will  possibly  permit. 

Persons  of  a Thoracic  Temperament,  having  a rapid  circulation, 
and  a fulness  of  blood,  are  most  liable  to  iriflammatory  diseases. 
When  fever  attacks  them,  they  have  what  is  called  a “ high  fever.” 
If  rheumatism  comes,  it  is  acute  rheumatism.  Disease  takes  hold  of 
them  smartly-  As  they  do  everything  with  emphasis  and  energy 


130  TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 

when  well,  so,  when  ill,  they  make  a business  of  it,  and  are  sick  with 
all  their  might. 

Stimulants  and  tonics  generally  make  such  persons  worse.  They 
want  sedatives,  and  diaphoretics,  and  sweats,  and  purgatives,  and 
leeches,  and  cups,  and  low  diet,  and  cold  bathing,  and  whatever  else 
will  slacken  the  ferocious  swiftness  of  their  circulation. 

Those  of  the  Abdominal  Temperament  are  not  particularly  sub- 
ject either  to  very  high  fevers,  or  to  those  typhoid  forms  which 
produce  sinking.  As  in  the  two  temperaments  noticed  above,  their 
complaints  chiefly  attack  the  organs  most  largely  developed.  Their 
diseases  affect  the  stomach,  the  liver,  the  spleen,  and  the  bowels. 
These  are  the  largest  organs  in  their  bodies,  and  are  most  used ; and, 
being  overworked,  they  fall  into  disease. 

As  these  persons  are  slothful  in  all  their  habits,  so  their  diseases 
run  a sluggish  course.  They  are  not  so  liable  to  sudden  death  as 
persons  of  either  of  the  preceding  temperaments.  They  have  all 
sorts  of  chronic  diseases  which  linger  a great  while,  and  are  cured 
with  much  difficulty. 

These  persons  will  bear  larger  doses  of  medicine  than  either  of 
the  preceding.  Neither  do  their  constitutions  respond  as  readily  to 
medicine.  A physician  will  be  disappointed  if  he  expects  to  see 
them  recovering  as  fast  under  its  use. 

Those  of  a Muscular  Temperament,  having  little  fondness  for 
anything  but  a hardy,  active  life,  are  much  exposed  to  the  elements. 
Though  strong  and  long-enduring,  the  hardship  of  their  lives  often 
breaks  them  down,  and  when  felled  by  disease,  they  are  oftentimes 
shockingly  racked  and  torn  by  it. 

These  persons  bear  large  doses  of  medicine,  and  when  sick,  need 
to  be  treated  with  an  energy  proportioned  to  the  strength  of  their 
constitution.  Rheumatism,  which  affects  the  joints,  the  ligaments, 
and  the  tendons,  is  an  affection  from  which  they  suffer  severely. 


The  Constitution. 

In  prescribing  for  disease,  it  is  of  very  great  importance  to  take 
notice  of  the  constitution.  This  is  a different  matter  from  the  tem- 
peraments. Persons  of  the  same  temperament  are  often  quite  unlike 
in  the  strength  of  their  constitution.  And  those  having  good  natural 
constitutions,  frequently  abuse  them  by  improper  habits  and  indul- 
gences, and  at  length  come  to  have  broken  and  very  feeble  consti- 
tutions. 

Some  persons’  muscles  and  other  tissues  are  put  together  as  if 
they  were  never  intended  to  come  apart.  Like  some  of  the  woods 
of  the  forest,  — the  lignum  vitse  for  example, — they  are  fine-grained 
and  tough.  A real  smart  boy  will  Avear  out  an  iron  rocking-horse 
sooner  than  one  of  these  persons  can  exhaust  their  constitution  by 


TEMPBKAMENTS,  CONSTITUTION,  AND  SYMPTOMS.  131 

hard  work.  Others,  to  outward  appearance  equally  well  made,  have 
very  little  endurance,  break  down  easily  under  hard  work,  and  lose 
their  flesh  from  trifling  causes. 

The  state  of  the  constitution,  therefore,  should  always  be  learned 
before  much  medicine  is  given ; for  what  a person  of  a strong  con- 
stitution will  need^  may  greatly  injure  a feeble  person,  even  of  the 
same  temperament. 

Habits. — These  must  likewise  be  attended  to.  Persons  using 
stimulants  require  larger  doses  of  medicine  to  affect  them  than  other 
persons. 

Climate. — Medicines  act  differently  on  the  same  persons  in  sum- 
mer and  winter.  Narcotics  act  more  powerfully  in  hot  weather  and 
climates  than  in  cold,  and  must  be  given  in  smaller  doses. 

Idiosyncrasy. — Medicines  of  only  ordinary  activity,  act  very  pow- 
erfully, and  even  violently  on  some  persons.  This  is  owing  to  a pecu- 
liarity of  stomach,  or  constitution,  called  idiosyncrasy.  It  makes  the 
person,  in  this  particular,  an  exception  to  the  general  rule.  And  no 
physician  can  know  beforehand  in  what  particulars  this  exceptional 
disposition  will  show  itself.  Persons,  however,  learn  their  own  idio- 
syncrasies, and  should  make  them  known  to  those  who  prescribe  for 
them  for  the  first  time. 

The  Sexi — The  peculiarities  of  each  sex  should  never  be  forgotten 
in  prescribing  for  the  sick. 

Males  are  not  so  sensitive  as  females.  They  will  bear  more  medi- 
cine, and  their  nervous  system  is  not  so  readily  excited  by  it. 

Influence  of  Age. — Human  life  is  divided  into  infancy,  childhood, 
youth,  manhood,  and  old  age.  Each  of  these  periods  has  peculiarities 
which  modify  disease. 

The  First  Period,  extending  from  birth  to  the  age  of  seven  years, 
is  marked  by  tenderness  and  excitability,  and  is  alive  to  every  irrita- 
tion. Teething  and  other  disturbances  occur  at  this  period,  and  need 
careful  management. 

The  Second  Period  extends  from  seven  to  fourteen,  and  is  quite 
subject  to  disease,  including  the  second  dentition.  During  these  two 
periods  there  is  no  great  difference  between  the  sexes ; both  are  ten- 
der, and  need  careful  watching. 

During  the  Third  Period,  the  changes  occur  which  mark  and  sepa- 
rate the  sexes.  This  is  a developing  period,  when  the  functions  be- 
come established,  and  the  frame  acquires  form,  proportion,  and 
strength. 

At  this  time,  hereditary  tendencies  to  disease,  latent  till  now,  begin 
to  show  themselves,  and  call  for  every  possible  endeavor  to  break 
them  up,  and  fortify  the  constitution. 


132 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 


The  Fourth  Period  embraces  the  vigorous  maturity  of  life,  when 
the  powers  of  body  and  mind,  in  both  sexes,  are  at  the  summit  of 
their  excellence.  The  functions  are  now  well  established.  It  is  dur- 
ing this  period  that  the  female  is  subject  to  most  of  the  harassing 
ailments  peculiar  to  her  sex.  So  numerous  are  these  complaints,  and 
so  large  and  valued  the  class  of  persons  affected  by  them,  that  he  who 
treats  them  with  the  greatest  skill,  and  with  the  delicacy  which  their 
.(lature  demands,  may  be  said  to  be  at  the  head  of  his  profession. 

The  Fifth  Period  is  that  of  old  age,  when  the  functions  are  declin- 
ing, and  the  frame  is  bending  under  the  weight  of  years.  Old  age 
begins  earlier  with  females  than  with  males.  Many  ailments  are  com- 
mon to  this  period,  which  require  peculiar  managemept,  both  medi- 
cinal and  hygienic. 

Proper  Frequency  of  Dose. — Each  succeeding  dose  should  be 
given  before  the  effect  of  the  preceding  is  gone.  If  this  rule  is  not 
attended  to,  the  cure  does  not  advance.  What  is  gained  by  each 
dose  is  lost  by  the  rallying  of  the  disease  in  the  interval.  Care  must 
be  taken,  however,  not  to  apply  this  rule  too  strictly  with  very  active 
medicines. 

How  to  Examine  a Patient. 

When  a patient  is  presented  for  examination,  having  observed  the 
temperament,  constitution,  sex,  and  age, 

1.  Learn  the  causes  of  the  disease,  whether  local,  specific,  or  gen- 
eral, and  also  its  history. 

2.  Search  out  its  nature  and  character,  whether  febrile  or  other- 
wise. 

3.  Take  notice  of  the  whole  train  of  symptoms,  — embracing  the 
pulse,  the  condition  of  the  mouth,  tongue,  and  digestive  organs,  the 
breathing,  the  urine,  the  fecal  discharges,  the  condition  of  the  brain 
and  nervous  system,  the  state  of  the  skin,  etc. 


Brief  Table  Explanatory  of  Symptoms. 

GENERAL  APPEARANCE  OF  PATIENT. 


1.  Tonic  spasm  of  the  trunk 

2.  Distorted  features,  altered  position, 

and  impaired  motion  of  limbs 

3.  Irregular  and  perpetual  motion 

4.  Entire  and  absolute  immobility 

5.  Great  and  unnatural  boldness 

6.  Great  and  unusual  languor 

7.  Ability  to  lie  only  upon  the  back 


8.  Lying  upon  the  face 

9.  Lying  upon  one  side 


Locked  jaws. 

Paralysis  of  one  side. 

St.  Vitus’s  dance. 

Catalepsy. 

Insanity  or  delirium. 

The  beginning  of  an  acute  disease,  or 
the  progress  of  a chronic  one. 

Apoplexy.  Organic  disease  of  the  brain 
or  spinal  marrow.  Acute  inflamma- 
tion of  the  lining  of  the  abdomen. 
Rheumatism  of  the  joints. 

Several  kinds  of  colics. 

Pleurisy,  or  inflammation  of  the  lungs. 
When  one  lung  only  is  affected  in 
consumption,  the  patient  generally 
lies  on  the  diseased  side. 


indicates 

it 


TEMPEEAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 


133 


20.  Maintaining  the  sitting  posture 
only 

11.  The  head  thrown  back 

12.  Bestlessness  and  tossings 

13.  General  enlargement  of  the  body 

Head,  Face, 


Disease  of  the  heart  or  lungs,  which 
interferes  with  breathing. 

Severe  diseases  of  the  larynx  and  wind- 
pipe. 

The  beginning  of  acute  inflammation. 

Fevers.  Delirium,  and  acute  mania. 
Cell-dropsy.  Emphysema  from  a 
wound  of  the  chest, 

and  Neck. 


indicates 


1.  Head  bent  to  one  side  indicates  Convulsions.  Paralysis  of  one-half  the 

body.  Dislocation  of  bones  of  neck. 


2.  Head  increased  in  size 

3.  Swollen  scalp 

4.  Dull  expression  of  face 

5.  Pull,  red  face,  with  blood-vessels 

of  eyes  injected 

6.  Pinched,  contracted  countenance 

7.  Pinched  nose,  sunken  eyes,  hollow 

temples,  skin  of  forehead  tense 
and  dry,  complexion  livid 

8.  Wrinkles  across  the  forehead 

9.  Wrinkles  from  forehead,  vertically 

to  root  of  nose 

10.  A white  line  from  inner  angle  of 

the  eye  to  just  below  the  cheek- 
bone 

11.  White  line  from  the  upper  border 

of  the  wing  of  the  nose  (ala  nasi ) , 
curved  to  the  outer  margin  of  the 
orb  of  the  eye 


12.  The  white  line  in  children  from 

angle  of  mouth  to  lower  part  of 
face 

13.  A white  line  external  to  the  last 

two,  in  a semicircular  direction 
towards  the  chin 

14.  Swelling  of  the  face  and  eyelids 

15.  Transient  redness  or  flushing  of 

16.  Hectic  flush 

17.  Paleness  of  face 


18.  Dingy,  white,  or  greenish  face 

19.  Yellow  tint 

20.  A citron  tint 

21.  A bluish  tint 

22.  Perpetual  motion  of  eyelids 

23.  Forcible  closure  of  eyelids 

24.  Eyelids  remaining  open 

25.  Palsy  of  the  upper  lid 

26.  Flowing  of  tears  over  the  cheek 

27.  Nostrils  dilating  forcibly  and  rap- 

idly 

28.  Itching  of  nostrils  in  children 


Swelling  of  glands  of  neck. 

Chronic  hydropholus.  Enlarged  brain. 
Erysipelas.  Small-pox. 

Typhoid  fever. 

Swelling  of  heart.  Congestion  of 
brain. 

Acute  inflammation  of  peritoneum. 

Exposure  to  severe  cold. 

Chronic  disease  just  before  death. 


Excessive  pain  arising  externally. 

Distress,  anxiety,  and  severe  internal 
pain. 

In  children,  a brain  or  nervous  affec- 
tion ; in  adults,  abuse  of  the  genera- 
tive organs. 

In  consumption  and  wasting  of  flesh. 
The  lower  part  of  the  line  indicates 
disease  of  stomach  ; the  upper  part, 
some  affection  of  upper  part  of  bowel. 
When  united  with  the  white  line 
named  above,  and  with  a drawing  in 
of  the  cheek,  fixed  eyes,  and  a wan 
complexion,  it  implies  worms. 

An  affection  of  the  chest,  with  difiB.- 
culty  of  breathing. 

Chronic  and  obstinate  disease  in  the 
chest  or  belly. 

Albumen  in  the  urine. 

Suffering  from  the  monthly  irregular- 
ity. 

Consumption.  Chronic  affections. 

Cold  stage  of  fever.  Acute  inflamma- 
tion. Chronic  diseases,  especially 
Bright’s  disease,  during  recovery. 

A low  and  deficient  state  of  blood. 

Jaundice. 

Cancerous  disease. 

Poor  circulation  in  the  veins.  Cholera. 
Typhus  fever.  Blue  disease. 

Mania  and  idiocy. 

Intolerance  or  dread  of  light. 

Orbicularis  palpebrarum.  Paralysis  of 
the  muscle  which  closes  the  eye. 

Injury  of  the  third  pair  of  nerves. 

Obstruction  of  the  lachrymal  duct. 

Difficulty  of  breathing. 

Worms  in  the  bowels. 


The  Tongue. 

1.  Surface  of  tongue  covered  with  a indicates  Derangement  of  stomach,  or  bowels,  or 
layer  of  whitish,  soft,  mucous  both, 

substance,  which  may  partially 
be  taken  off  with  a scraper, 
also,  clammy  mouth 


134 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 


2.  State  of  tongue  as  above,  with 

clammy  mouth,  bitter  taste,  and 
fetid  breath. 

3.  Great  load  on  tongue  as  above, 

which  peels  off,  leaving  the 
tongue  smooth,  red  and  tender 

4.  Tongue  slightly  white  from  small 

white  points,  and  sometimes  cov- 
ered with  fur,  like  the  fibres  of 
coarse  velvet 

6.  Tongue  pale,  tumid,  clean  and  very 
smooth 

6.  Tongue /M?red  and 

7.  Tongue  white  and  loaded,  with 

much  thirst 

8.  As  above  at  first,  — afterwards 

clean,  red,  and  dry 

9.  Tongue  white  and  loaded,  with  dry- 

ness 

10.  Tongue  dry,  parched,  tender,  and 

dark  brown  or  black.  Pushed  out 
with  great  difiiculty  and  tremb- 
ling 

11.  Tongue  loaded  with  white,  through 

which  numerous  elongated,  very 
red  papillae  protrude  their  points 


indicates  Acute  dyspepsia.  Asthma. 

“ Severe  cases  of  acute  dyspepsia. 

“ Chronic  dyspepsia.  Some  affection  of 

the  liver,  if  the  fur  be  yellow. 

“ Chlorosis  or  green  sickness. 

“ Violent  local  inflammation.  Irritation 

in  bowels. 

“ Inflammatory  fever. 

“ Protracted  inflammatory  fever. 

“ Mild  typhus  fever. 

“ Severer  forms  of  typhus  fever. 

“ Scarlet  fever. 


The  Throat. 


1.  Throat  enlarged 

2.  Violent  pulsation  of  carotid  arteries 


3.  Pulsation  of  the  nameless  artery 

(arteria  innominata)  above  the 
breast  bone,  and  to  the  right  of 
the  windpipe. 

4 . Circumscribed  swelling  about  throat 


The  approach  of  puberty  in  females. 
Acute  mania.  Inflammation  of  brain. 
Enlargement  of  heart,  and  dilation 
of  right  ventricle.  Anemia. 
Regurgitation  from  aorta. 


Enlargement  of  glands. 


indicates 


The  Chest. 


1.  General  enlargement  of  one  side  of 

chest 

2.  Bulging  at  the  base  of  a lung 

3.  Bulging  at  front  upper  part  of  chest 

4.  Bulging  right  hypochondrium  (Sea 

Fig.  95) 

5.  Bulging  in  region  of  heart 

6.  Tumor  where  the  third  rib  joins  the 

breast-bone 

7.  Tumor  between  the  base  of  the 

shoulder  blade  and  the  spine 

8.  Depression  or  retraction  of  one  side 

of  chest 

9.  Breathing  increased  in  rapidity. 

Generally,  in  health,  about 
twenty  breaths  are  taken  in  a 
minute 

10.  Breathing  diminished  in  rapidity 


11.  Jerking  respiration 

12.  Breathing  with  muscles  of  ribs  only 


The 


indicates  Large  effusion  of  water  from  pleurisy. 

“ Water  from  pleurisy  settling  to  the 

bottom. 

“ Emphysema. 

“ Enlargement  of  liver. 

“ Water  in  heart-case.  Enlargement  of 

heart. 

“ Aneurism  of  the  ascending  aorta. 

“ Aneurism  of  the  descending  aorta. 

“ Consumption.  Absorption  of  fluid, 

effused  by  pleurisy. 

“ Spasmodic  asthma. 


“ Pleurisy.  Paralysis  of  respiratory  mus- 

cles. Inflammation  of  lungs.  Emphy- 
sema. Pneumothorax.  Consumption. 

“ Spasmodic  asthma.  Obstruction  in 

larynx  and  windpipe. 

“ Abdominal  inflammation.  Inflamma- 

tion of  diaphragm. 

Belly. 


1.  Increased  size  of  belly  indicates  Dropsy.  Wind  in  bowels.  Inflam- 

mation of  peritoneum.  Obstruction 
in  bowels.  Hysteria. 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 


135 


2.  Enlargement  in  epigastrium  (Fig.  93)  indicates  Hysteria.  Cancer  of  stomach. 

3.  Enlargement  in  hypogastrium  (Fig.  95)  “ Distension  of  bladder.  Ovarian  tu- 

mors. Accumulation  of  feces  in 
bowels. 

4.  Belly  diminished  in  size  " Chronic  dysentery.  Lead  colic.  Also 

in  most  chronic  diseases. 


t.  Enlarged  penis  in  children 

2.  Drawing  up  of  testicles 

3.  Enlargement  of  scrotum 


Private  Organs. 

indicates  Stone  in  bladder.  Masturbation. 

“ Stone  in  kidneys. 

“ Hydrocele.  Hematocele.  Sarocele. 


1.  The  limbs  immovable 

2.  Limbs  contracted  and  rigid 

3.  General  swelling  of  limbs 

4.  Swelling  of  joints 

5.  Limbs  diminished  in  size 


The  Limbs. 

indicates  Paralysis. 

“ Softening  of  the  brain. 

“ Defective  circulation  of  blood. 

“ Rheumatism.  Water  in  the  joints. 

White  swelling. 

“ Paralysis. 


The  Nervous  System. 


1.  Morbidly  increased  sensation 

2.  Tensive  pain 

3.  Dull,  heavy  pain 


4.  Smarting  pain 

5.  Shooting,  tearing  pains 

6.  Boring  pains 

7.  Contusive  pains. 

8.  Itching.  Sensation  as  of  ants  creep- 

ing over  the  skin 

9.  Exaltation  of  vision 

10.  Black  flecks  floating  before  the 

eyes 

11.  Painfully  acute  hearing 

12.  Dull  hearing 

13.  Increase  of  strength 

14.  Debility 

15.  Trembling 


16.  Rigidity  of  upper  extremities 

17.  Cramp 

18.  Temporary  spasm 

19.  Pain  at  extremity  of  penis 

20.  Pain  in  right  shoulder 

21.  Pain  in  left  shoulder 

22.  Exaltation  of  affections 

23.  Loss  of  moral  sensibility 

24.  Exaltation  of  intellect 


indicates  Acute  inflammation  of  brain  and 
spinal  marrow.  Fevers.  Hysteria. 

“ Phlegmonous  inflammation. 

“ Enlarged  internal  organs.  Internal 

tumor.  Effusion  of  water  into  cavi- 
ties lined  with  serous  membranes. 
Felt  in  the  loins  previous  to  dis- 
charge from  menstruation,  and  from 
piles. 

“ Scarf-skin  removed. 

“ Neuralgia.  Cancer. 

“ Constitutional  syphilis.  Rheumatism. 

Gout.  Inflammation  of  periosteum. 

“ Bruises.  Acute  diseases. 

“ Several  diseases  of  the  skin. 

“ Ophthalmia.  Inflammation  of  brain. 

Some  nervous  diseases. 

“ Affections  of  the  brain  and  optic 

nerve.  Dyspepsia. 

“ Inflammation  of  brain.  Hysteria. 

“ Typhus  fever. 

“ Delirium.  Inflammation  of  brain. 

Mania. 

“ Most  diseases. 

“ Cold  stage  of  fever.  Nervous  affec- 

tions. Old  age.  Action  on  the  sys- 
tem of  lead,  mercury,  strong  coffee, 
alcoholic  drink,  tobacco,  opium. 

“ Softening  of  the  brain.  Infiltration 

of  blood  into  the  brain.  Hysteria. 

“ Pregnancy.  Hysteria.  Painters’  colic. 

“ In  convulsions  of  children.  Some 

affections  of  the  brain. 

“ Stone  in  bladder. 

“ Congestion  of  liver. 

“ Disordered  stomach. 

“ Hypochondriasis. 

“ Mania.  Typhus  fever.  Masturbation. 

“ Melancholy.  Sometimes  indicates 

close  of  life. 


The  Breathing. 

1.  Stiffness  of  chest  indicates  Cartilages  turned  to  bone.  Pleura 

hardened.  Distortion  from  rickets. 

2.  Pressure  upon  parts  “ Tumors.  Dropsy  of  belly. 


V 


136 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 


3.  Obstruction  of  air-tubes  indicates  Spasm  of  glottis.  Spasm  near  the 

small  ends  of  bronchial  tubes. 


4.  Compression  of  lungs 


6.  Pain  in  parts  moved  in  breathing 

6.  Paralysis  of  muscles  of  chest 

7.  Spasm  of  muscles  of  chest 

8.  Deficiency  of  red  blood 


Mucus,  etc.,  thrown  out  upon  the 
inner  surface. 

Effusions  in  pleurisy.  Water  in 
chest.  Air  in  substance  of  limgs. 
Aneurism  and  other  tumors. 

Pleurisy.  Inflammation  of  perito- 
neum. 

Injury  of  spinal  marrow. 

Locked  jaw.  Spasmodic  asthma. 

Anaemia,  Chlorosis  or  green  sickness. 


The  Cough. 

1.  Hollow  and  harking  cough  indicates  Last  stage  of  consumption.  Chronic 

bronchitis.  Some  nervous  affections. 


2.  Sharp,  ringing  cough 

3.  Hoarse  cough 

4.  Wheezing  cough 

5.  Belching  cough 

6.  Cough  in  paroxysms 

7.  Cough  sounding  harsh  and  concen- 

trated when  listening  with  the 
stethoscope. 

8.  Cough  sounding  hollow,  when  lis- 

tening with  the  stethoscope,  as 
thou^  it  came  from  a cavern. 

9.  Cough  having  a metallic  or  ringing 

sound  when  listening  with  the 
stethoscope. 


Croup, 

Beginning  of  cold.  Chronic  laryn- 
gitis. 

Asthma. 

Some  diseases  of  larynx. 

Hooping  cough.  Hysteria. 

Consumption.  Inflammation  of  the 
lungs.  Pleurisy.  Enlargement  of 
bronchial  tubes. 

Tuberculous  cavity.  Enlarged  bron- 
chial tubes. 

Large  tuberculous  cavity. 


The  Expectoration. 


1 . Scanty  expectoration 

2.  Copious  expectoration 

3.  Watery  expectoration 

4.  Mucous  expectoration 

5.  Expectoration  of  pus 

6.  Expectorated  matter  shaped  like 

coin  (nummular) 

7.  Muco-purulent,  floculent  expecto- 

ration 

8.  Tubular  expectoration 

9.  Whitish  or  greenish  expectoration, 

that  clings  to  the  vessel 

10.  Y'ellow  expectoration 

11.  Rusty  expectoration 

12.  Putrid  smell  of  expectoration 

13.  Faint  and  sweetish  smell  of  expec- 

toration. 

14.  Expectoration  smelling  like  garlic 


indicates  First  stage  of  acute  diseases  of  the 
lungs. 

“ Decline  of  acute  diseases  of  air-passages 

and  lungs. 

“ Beginning  of  bronchitis.  Congestion 

of  lungs.  Vesicular  emphysema. 

“ Bronchitis.  Inflammation  of  lungs. 

“ Consumption.  Third  stage  of  inflam- 

mation of  lungs. 

“ Tubercular  consumption.  Bronchitis 

of  measles. 

“ Consumption  far  advanced. 

“ Plastic  bronchitis.  Pneumonia. 

“ Acute  affections  of  lungs,  particularly 

bronchitis 

“ Chronic  bronchitis.  Other  chronic  af- 

fections of  the  lungs  and  throat. 

“ Inflammation  of  the  lungs. 

“ Gangrene  of  the  lungs. 

“ Bronchitis.  First  stage  of  consumption. 

“ Broncho-pleural  fistula. 


Pain. 

1.  Dull,  heavy,  aching  pain  at  the  indicates  Acute  bronchitis. 

base  of  the  chest 

2.  Soreness  about  the  breast  bone,  and  “ Acute  bronchitis. 

between  the  shoulders 

3.  Sharp,  sudden,  tearing  pain  below  “ Pleurisy. 

the  nipple 

4.  Pain  darting  from  front  part  of  “ Consumption. 

chest  to  between  shoulder  blades 

5.  Constant  pain  between  the  shoulders  “ Consumption.  Greensickness.  Other 

chrome  diseases. 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 


137 


1. 


2. 

3. 

i. 

5. 

6. 

7. 

8. 


1. 

2. 

3. 

4. 

5. 

6. 


7. 

8. 

9. 

10. 

11. 

12. 

13. 

14. 

15. 


16. 

17. 

18. 

19. 

20. 
21. 
22. 
23. 


The  Pulse. 


Strong  pulse,  resisting  compression 
by  the  finger 

Weak  pulse,  easily  pressed  down 


Full  pulse,  as  if  the  artery  were  in- 
creased in  size 
Small  pulse,  opposite  of  full 


Hard,  sharp,  contracted  pulse,  — vi- 
brating like  a cord  under  the  finger 
Soft  pulse,  3uelding  readily  to  pres- 
sure 

Frequent  pulse 
Slow  pulse 


Inflammatory  affections,  especially  of 
the  substance  of  large  organs,  as  the 
liver,  etc. 

Prostration  from  disease.  Nervous  and 
chronic  affections.  Fear.  Diseases 
of  women  and  children,  and  old  per- 
sons. 

Congestion  of  brain.  Apoplexy.  Dis- 
ease of  heart. 

Inflammation  of  stomach,  bowels, 
bladder,  etc.  Hysteria,  and  other 
nervous  affections. 

Inflammation  of  membranes.  Active 
bleedings.  Lead  colic,  etc. 

Affections  characterized  by  debility. 

Inflammatory  diseases.  Hemorrhages. 

Apoplexy,  Sometimes  in  disease  of 
heart. 


indicates 


Relating  to  Digestion. 


Tongue  trembling  and  dry,  and  di- 
minished in  size 
Voracious  appetite 

Diminished  appetite 
Increased  thirst 
Thirst  gone 
Vomiting 


Pain  increased  by  pressure 
Pain  relieved  by  pressme 

Urgent  desire  to  go  to  stool 
W atery  stools 

Mucous  stools,  like  white  of  egg 
Hard  and  lumpy  stools 

Clay-colored  stools 
Yellow  or  dark-brown  stools 
Dark-green  stools 

Stools  red,  and  streaked  with  blood 
Pitchy  black  stools 
Stools  pure  blood,  with  no  colic 
Stools  like  rice-water 
Black  stools 

Shreds  of  false  membrane  in  stools 
Fat  with  stools 
Fetid  stools 


Typhoid  and  other  low  fevers. 

Pregnancy.  Hysteria.  Insanity.  Some- 
times in  dyspepsia. 

In  most  acute  diseases. 

Acute  affections  of  stomach  and  bowels. 
Cerebral  disease,  with  coma. 

Early  pregnancy.  Colic.  Disease  of 
brain.  Inflammation  of  stomach. 
Hernia. 

Inflammation  of  internal  organs. 
Over-distension  of  bowels.  Neuralgia. 
Colic. 

Dysentery.  Sometimes  in  diarrhoea. 
Diarrhoea.  Cholera. 

Chronic  inflammation  of  colon. 
Constipation.  Colic.  Cancer  of  stom- 
ach. 

Deficiency  of  bile. 

Too  much  bile. 

Bile  from  children  after  taking  cal- 
omel. 

Dysentery. 

Melaena. 

Bleeding  piles. 

Asiatic  cholera. 

Iron  taken  in  medicine. 

Dysentery.  Diarrhoea.  Worms. 
Diabetes.  Consumption. 

Diseases  attended  by  debility. 


indicates 

ft 


The  Urine. 


1.  Diminished  secretion  of  urine 

2.  Retention  of  urine  in  the  bladder 

3.  Urine  increased  in  amount 

4.  Red  or  yellow  sand  deposits  in  urine 

(uric  acid) 

5.  White  sediment  in  urine  (earthy 

phosphates) 

6.  Oxalate  of  lime  deposits  in  urine 

7.  Blood  in  urine 

8.  Albumen  in  urine 

9.  Mucus  in  urine 

10.  Sugar  in  urine 


indicates  Dropsy.  Inflammatory  and  febrile 
diseases. 

“ Paralysis.  Typhoid  fever.  Hysteria. 

“ Diabetes.  Cold  stage  of  fevers.  Hy- 

steria. V arious  passions  of  the  mind. 

“ Fevers.  Acute  Rheumatism.  Con- 

sumption. Dyspepsia.  Great  indul- 
gence in  animal  food. 

“ Depressed  state  of  the  nervous  system, 

of  serious  import. 

“ Derangement  of  digestion. 

“ Bleeding  of  kidneys,  etc. 

“ Bright’s  disease. 

“ Inflamed  mucous  membrane  of  ure- 

“ thra,  bladder,  etc, 

“ Diabetes. 


138 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 


The  Perspiration. 


1.  Profuse  perspiration  indicates  Acute  rheumatism.  Decline  of  acute 

“ inflammations  and  fevers,  being 

sometimes  critical. 


2.  Diminished  perspiration 

3.  Night  sweats 

4.  Sour-smelling  sweat 

6.  Fetid  smelling  sweat 

6.  Sweat  with  mouldy  odor 

7.  Smelling  like  ammonia 

8.  Sweat  having  the  odor  of  mice 

9.  Sweat  smelling  like  rottenstone 


Early  stage  of  acute  disease.  Dropsy. 

Diabetes. 

Consumption. 

Rheumatism.  Gout. 

Some  debilitating  fevers. 

Measles.  Scarlet  fever. 

Typhoid  fever  sometimes. 

Insanity. 

Miliary. 


The  Temperature, 


1.  General  heat  of  surface 

2.  External  local  heat 

3.  Hot  forehead 

4.  Hot  scalp 

5.  Skin  of  chest  hot 

6.  Hands  and  feet  hot. 

7.  Acrid  heat,  burning  the  hand  when 

applied 

8.  Chills 

9.  Low  temperature 
10.  Cold  hands  and  feet 


indicates  Fevers. 

Inflammation. 

“ Headache. 

“ Disease  of  brain. 

“ Inflammation  in  chest. 

“ Consumption. 

“ Typhus  fever. 

“ Beginning  of  fever. 

“ Poor  circulation. 

“ Nervous  diseases.  Dyspepsia.  Impure 

state  of  the  blood. 


The  Temperature  of  the  Body. 

The  use  of  the  thermometer  is  an  important  addition  to  the  means 
of  making  physical  examination,  and  is  one  of  the  improvements  in 
modern  medicine. 

It  is  intended  to  measure  the  heat  of  the  body. 

The  best  kind  now  in  use  is  the  self-registering. 

The  bulb  of  the  instrument  is  to  be  placed  in  the  warmest  part  of 
the  body,  and  should  be  allowed  to  remain  there  for  eight  to  ten 
minutes. 

Some  place  it  under  the  tongue  ; some  in  the  axilla. 

Sometimes  it  is  necessary  to  introduce  it  into  the  rectum  or  vagina. 
In  these  parts  the  temperature  is  a degree  higher  than  in  other  parts. 

The  normal  temperature  of  the  body  is  from  98°  to  99°  Fahrenheit, 
in  the  great  majority  of  persons. 

Exceptionally  it  may  be  half  or  a whole  degree  either  above  or  be- 
low this  range. 

The  normal  fluctuations  are  inconsiderable  in  comparison  with  the 
variations  of  disease. 

The  natural  variations  in  health  are  as  follows  : The  temperature 
is  at  its  minimum  at  five  o’clock  A.  M.  ; the  maximum  is  reached  in 
the  latter  part  of  the  afternoon,  and  then  decreases  till  five  o’clock 

A.  M. 

By  means  of  the  thermometer  we  are  able  to  determine  all  differ- 
ences with  precision. 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 


139 


The  increase  of  heat  in  different  febrile  diseases  rarely  exceeds 
110°  Fahrenheit,  and  as  a rule  the  amount  of  increase  is  a criterion 
of  its  severity. 

An  increase  to  100°  Fahrenheit  or  101°  is  evidence  of  mildness  of 
the  disease. 

If  the  thermometer  indicates  steadily  105°  Fahrenheit,  it  is  certain 
that  the  disease  is  severe. 

A persisting  temperature  above  105°  Fahrenheit  denotes  that  there 
is  great  danger,  and  an  increase  to  108°  to  110°  Fahrenheit  is  usually 
a fatal  sign. 

The  abnormal  changes  of  temperature  consist  of  more  or  less  in- 
crease. 

Diminution  below  the  normal  standard  is  comparatively  rare  ; yet 
it  sometimes  occurs  and  is  of  some  importance. 

In  the  course  of  typhoid  fever,  a sudden  decrease  may  indicate  in- 
testinal hemorrhage.  Sometimes  the  temperature  falls  without  im- 
provement in  the  other  symptoms.  This  is  an  unfavorable  symptom. 

The  value  of  thermometric  changes  depends  in  no  small  measure 
upon  the  symptoms  with  which  they  are  associated. 

Sickness  during  Life. 

It  is  estimated  that  2 years’  sickness  is  experienced  by  every  person 
before  they  are  70  years  old,  and  that  10  days  per  annum  is  the  aver- 
age sickness  of  human  life.  Till  40  it  is  half,  and  after  50  increases 
The  miscellaneous  diet  of  man  is  the  cause  of  many  diseases. 

Human  Longevity. 

Of  100,000  male  and  female  children,  in  the  first  month  of  life  they 
are  reduced  to  90,506  or  nearly  a tenth.  In  the  second  to  88,155. 
In  the  third  to  85,976.  In  the  fourth  to  85,139.  In  the  fifth  to  84,- 
122.  In  the  sixth  to  82,635,  and  by  the  end  of  the  first  year  to 
76,938,  the  deaths  being  2 in  10.  The  next  four  years  reduces  the 
76,938  to  63,048,  indicating  36,952  deaths  before  the  completion  of 
the  fifth  year. 

At  25  years  the  100,000  are  about  half,  or  49,695,*  at  55  about  a 
third;  at  59  about  a fourth,  or  about  25,000;  at  67  about  a fifth; 
at  75,  a tenth;  at  80,  a twentieth,  or  5,000,  and  10  attain  100  years. 

About  the  age  of  35  the  lean  man  usually  becomes  fatter,  and  the 
fat  man  leaner.  Again,  between  the  years  45  and  50  is  generally  a 
critical  time  in  a man’s  life,  his  appetite  fails,  he  becomes  logy,  and 
tires  easily  upon  the  least  exertion  of  body  or  mind.  His  muscles 
become  flabby,  his  spirits  droop  and  his  sleep  is  poor  and  unrefresh- 
ing. After  suffering  under  these  complaints  a year  or  two,  he  seems 
to  acquire  new  vigor,  and  goes  on  to  62  or  63,  when  a similar  change 
takes  place,  but  when  improvement  comes  he  is  apt  to  go  on  to  a ripe 
old  age, 


140 


TEMPERAMENTS,  CONSTITUTION  AND  SYMPTOMS. 


Strength  and  Warmth  Derived  from  Different 
Articles  of  Food  and  Drink. 


Strength  derived  from  articles 
of  food  and  drink. 

Grains  of  Strength  yielded  by 


Warmth  derived  from  one 
pound  of  different  articlesof  food 
Grains  of  Warmth  yielded  by 


one  pound  of  7,000  grains. 

Grains 

one  pound  of  7,000  grains 

Grains 

Parsnips, 

12 

Whey, 

151 

Turnips, 

13 

Turnips, 

238 

Whey, 

13 

Buttermilk,  .... 

335 

Greens, 

14 

Skimmed  Milk,  . 

352 

Potatoes, 

24 

New  Milk,  .... 

378 

Skimmed  Milk, 

35 

Carrots, 

Parsnips,  .... 

390 

New  Milk, 

35 

426 

Buttermilk,  .... 

36 

Potatoes,  .... 

770 

Barley, 

70 

Fresh  Fish,  .... 

980 

Rice, 

70 

Beef  Liver,  .... 

1,220 

Bacon, 

78 

Red  Herrings,  . 

1,456 

Rye  Bread,  .... 

89 

Baker’s  Bread,  . 

1,990 

Baker’s  Bread, 

90 

Fresh  Beef,  .... 

2,300 

Fresh  Pork,  .... 

109 

Molasses,  .... 

2,300 

Corn  Meal, 

125 

Skim  Milk  Cheese,  . 

2,355 

Fresh  Fish,  .... 

129 

Seconds  Flour,  . 

2,700 

Cocoa,  

130 

Rye  Bread,  .... 

2,700 

Oatmeal, 

140 

Rice,  

2,755 

Mutton, 

140 

Barley  Meal, 

2,780 

Fresh  Beef,  .... 

173 

Indian  Meal, 

2,806 

Beef  Liver,  .... 

200 

Sugar, 

2,900 

Split  Peas, 

250 

Fresh  Pork,  .... 

3,100 

Cheddar  Cheese,  . 

310 

Bacon, 

4,201 

Skim  Milk  Cheese  . 

361 

Butter, 

Lard,  . , . . . 

4,700 

4,806 

TEMPERAMENTS,  CONSTITUTION  AND  SYMPTOMS. 


141 


The  stature  of  the  body  at  birth 
and  subsequent  ages. 


The  additional  length  of  life  a oer- 
son  is  expected  to  live  after  reaching 
the  age  of  years  and  each  subse- 
quent year  to  70  years  old. 


STATURE  OF  MALES 

STATURE  OF 

FEMALES 

YEARS 

YEARS 

Age 

Feet 

Lbs. 

Age 

Feet 

Lbs. 

Age 

Expec- 

tancy 

Age 

Expec- 

tancy 

0 

1.65 

7.05 

0 

1.63 

6.42 

20 

4U 

46 

24 

2 

2.60 

25.02 

2 

2.55 

23.53 

21 

40| 

47 

23i 

4 

3.05 

31.38 

4 

3.01 

28.67 

22 

40 

48 

22i 

6 

3.44 

38.81 

6 

3.38 

35.29 

23 

391 

49 

22 

9 

4.01 

49.95 

9 

3.93 

47.10 

24 

381 

50 

211 

11 

4.36 

59.78 

11 

4.26 

56.57 

25 

38 

51 

20i 

13 

4.73 

75.81 

13 

4.61 

72.65 

26 

37J 

52 

19i 

15 

5.08 

96.40 

15 

4.92 

89.04 

27 

36^ 

53 

19 

17 

5.36 

116.56 

17 

5.10 

104.34 

28 

35| 

54 

m 

18 

5.44 

127.60 

18 

5.15 

112.55 

29 

35 

55 

17f 

20 

5.50 

132.46 

20 

5.16 

115.30 

30 

34| 

56 

17 

30 

5.52 

140.38 

30 

5.18 

119.82 

31 

33f 

57 

16| 

40 

5.52 

140.43 

40 

5.18 

121.81 

32 

33 

58 

15i 

50 

5.50 

139.96 

50 

5.05 

123.86 

33 

321 

59 

15 

60 

5.38 

136.08 

60 

4.98 

119.76 

34 

31| 

60 

14i 

70 

5.32 

131.28 

70 

4.97 

113.60 

35 

31 

61 

14 

80 

5.29 

127.55 

80 

4.95 

108.80 

36 

30^ 

62 

13h 

90 

5.28 

127.54 

90 

4.94 

108.81 

37 

29 1 

63 

13 

38 

29 

64 

12^ 

39 

28i 

65 

111 

40 

27| 

66 

m 

41 

27 

67 

10| 

42 

26i 

68 

lOi 

43 

25| 

69 

9| 

44 

25i 

70 

9| 

45 

24^ 

Weight  of  the  Human  Body. 

The  weight  of  the  male  at  birth  is  7 lbs.,  that  of  the  female  is 
about  lbs.  The  maximum  weight  (140^  lbs.)  of  the  male  is  at- 
tained at  40;  that  of  the  female  (nearly  124  lbs.)  is  attained  at  50. 
The  full  grown  adult  is  20  times  as  heavy  as  a new-born  infant.  In 
the  first  year  he  triples  his  weight.  At  an  equality  of  age  the  male 
is  heavier  than  the  female.  Towards  the  age  of  12  years  only,  an 
individual  of  each  sex  has  the  same  weight. 

Children  lose  weight  the  first  three  days  after  birth;  at  the  age  of 
a week  their  weight  gradually  increases;  after  1 year  they  triple  in 
weight  and  require  6 years  to  double  their  weight,  and  13  to  quad- 
ruple it. 


SYMPTOMS 

That  quickly  tell  what  your  complaint  is. 

Backache. 

Leucorrhea.  Whites. — Discharge  from  the  vagina  (catarrh) 
slight  or  profuse;  thin,  glairy;  thick,  lumpy  or  stringy;  watery  or 
milky;  yellowish,  greenish,  bloody  or  purulent;  odorless  or  offensive; 
bland  or  excoriating,  with  heat,  burning  and  itching  of  genitals; 
headache;  dizziness;  backache;  indigestion. 

Displacement  of  the  Uterus. — Weight  in  lower  abdomen;  pressing 
and  bearing  down  sensations;  disturbances  of  menstruation;  back- 
ache. 

Bowels, 

Hernia.  Rupture. — May  be  protrusion  of  intestines  in  groin, 
which  can  be  pushed  back;  or  strangulated,  when  not  reducible, 
with  inflammation,  pain,  nausea,  vomiting,  constipation,  cold  sweat, 
anxiety,  gangrene. 

Colic,  Intestinal. — Paroxysms  of  severe,  twisting  or  boring  pain, 
centering  about  navel,  radiating  through  abdomen,  better  from 
friction  and  pressure;  abdomen  usually  distended;  may  be  cold 
sweat,  feeble  pulse,  and  vomiting. 

Inflammation  of  the  Bowels.— Colicky  pains  in  the  bowels;  diar- 
rhoea, with  thin,  liquid  stools  containing  undigested  food  and  mucus, 
sometimes  blood-streaked;  tenderness;  high  fever;  rapid  pulse;  pa- 
tient lies  on  back,  with  legs  drawn  up. 

Peritonitis,  Acute. — Sudden  onset,  with  chill;  sharp,  and  cutting 
pains  in  abdomen,  with  great  tenderness;  distention  of  bowels  with 
gas;  high  fever;  hiccough;  nausea,  vomiting,  and  constipation;  pa- 
tient lies  on  back  with  knees  drawn  up;  pulse  small,  rapid,  "wiry.” 

Dysentery. — Constant  desire  to  evacuate  the  bowels,  with  much 
straining,  and  never-get-done  feeling;  small  stools  containing  mucus 
and  blood;  pain;  tenderness;  prostration. 

Cholera  Morbus. — Cramps  in  the  stomach  and  abdomen;  vomiting 
and  purging  of  bilious  matter;  frequent  and  copious  evacuations; 
thirst;  moderate  fever;  headache;  great  prostration;  coldness  of  ex- 
tremities. 


142 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS.  143 

Cholera  Infantum. — Vomiting  and  pm’ging;  thin,  watery,  musty 
smelling  stools;  intense  thirst;  great  restlessness;  hollow  eyes; 
pinched,  pale  face;  rapid,  feeble  pulse;  rapid  emaciation;  great 
exhaustion. 

Chills. 

Influenza.  La  Grippe. — Abrupt  onset;  great  prostration;  chil- 
liness; stiffness,  bruised  pain  in  muscles  of  neck,  back  and  legs;  severe 
pain  in  head;  sneezing,  hoarseness  and  paroxysmal  hard  cough; 
running  from  nose;  breathing  difficult;  or  acute  nervous  symptoms 
with  sleeplessness,  intolerable  pain  in  head,  delirium,  meningitis 
or  severe  gastric  disturbance  or  symptoms  as  in  typhoid  fever. 

Bronchitis,  Acute. — Chilliness;  debility;  soreness  and  constric- 
tion behind  breast  bone;  slight  fever;  irritative,  dry,  painful  cough 
becoming  loose,  with  partly  mucous,  partly  purulent  expectoration; 
difficult  breathing. 

Mumps. — Chilliness;  debility;  moderate  fever;  pain  in  angle  of 
the  jaw;  doughy  swelling  of  parotid  gland;  often  swelling  of  other 
glands  under  one  or  both  sides  of  jaw,  and  in  throat;  increase  of 
sahva;  may  be  sympathetic  swelling  of  breasts  or  testicles. 

Bright’s  Disease,  Acute.— Chill  followed  by  fever;  nausea;  face 
puffy;  extremities  swollen  and  dropsical;  dull  pain  over  kidneys, 
extending  downward;  frequent  urination;  quantity  of  urine  dimin- 
ished; urine  smoky,  reddish,  turbid  and  contains  albumen. 

Bright’s  Disease,  Chronic. — Slower  development  of  symptoms  as 
in  acute  form;  general  debility;  headache;  indigestion;  lassitude; 
nausea;  drowsiness;  much  swelling  and  dropsy. 

Cough. 

Bronchitis,  Chronic.  Winter  Cough. — Persistent  cough,  with  more 
or  less  partly  mucous,  partly  purulent  expectoration;  soreness  be- 
hind breast  bone;  shortness  of  breath;  oppression;  rales  in  chest. 

Croup,  False  Membranous. — Peculiar  ringing  cough,  becoming 
muffled;  hoarseness  and  difficult  breathing  continue  after  a spasm 
passes;  false  membrane  is  coughed  up;  great  restlessness  and  agita- 
tion; clutching  at  the  throat. 

Whooping  Cough. — In  the  beginning,  slight  fever,  sneezing,  run- 
ning from  the  nose,  dry  cough;  in  one  or  two  weeks  cough  more 
violent  and  in  hard  paroxysms,  with  eyes  congested,  face  bluish, 
veins  disturbed,  often  vomiting,  may  be  nosebleed,  long  drawn, 
shrill  whoop  at  end  of  paroxysm. 

Asthma. — Sudden  attacks  generally  at  night;  great  oppression 
in  chest;  distressed  breathing,  cannot  “catch  his  breath;”  profuse 
perspiration;  face  pale  and  anxious;  cough  and  expectoration  of 
thick,  tenacious  mucus;  loud  wheezing  in  chest. 


144 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 


Constipation. 

Prolapsus  Ani. — Descent  or  protrusion  of  mucous  membrane  of 
lower  bowel  through  the  anus;  irritation;  constipation;  straining  at 
stool. 

Piles. — Veins  of  rectum  distended  in  little  lumps;  may  protrude, 
bleed,  itch,  be  sore,  cause  or  aggravate  constipation. 

Depression. 

Hydrophobia. — Anxiety;  depression;  restlessness;  pain  in  wound; 
slight  fever;  increasing  difficulty  in  swallowing;  spasm  of  muscles  of 
neck,  especially  at  sight  of  water;  salivation;  convulsions;  delirium; 
exhaustion;  suffocation;  heart  failure. 

Opium  Poisoning,  Chronic. — Loss  of  flesh  and  strength;  trembling; 
debility;  sallow  complexion;  loss  of  appetite;  disturbed  sleep;  men- 
tal depression;  irritability;  tendency  to  lie  and  deceive;  irresistible 
craving  for  the  drug. 

Eyelids. 

stye, — Small,  painful  boil  on  eyelid,  with  heat,  redness,  swelling, 
and  rapid  suppuration. 

Tracoma. — Inflammation  and  thickening  of  the  lining  mem- 
brane of  the  eyelids,  with  formation  of  granulations  on  inner  side 
of  lids. 

Ear. 

Inflammation  of  Middle  Ear.  Otitis  Media. — Inflammation; 
pain;  swelling  of  the  drum  and  lining  membrane  of  middle  ear;  watery 
discharge;  with  suppurating  form,  acute  pain;  ringing  in  ear;  deaf- 
ness; fever;  formation  of  pus;  bulging  of  drum  which  may  rupture. 

Fever. 

Chicken  Pox. — Fever;  chilliness;  sparse,  superflcial  eruption  ol 
crop  of  pimples,  most  abundant  on  the  trunk,  drying  up  in  two  or 
three  days,  with  depressed,  blackish  crust  in  centre. 

Fever  and  Ague. — Debility;  nausea;  vertigo;  shivering,  increase 
ing  to  severe  chill,  with  chattering  of  teeth;  “goose  skin”;  hurried 
shallow  breathing;  small,  rapid  pulse.  Chill,  followed  by  fever, 
with  face  flushed;  eyes  red;  pulse  full  and  rapid;  pain  in  back  and 
limbs;  intense  thirst;  urine  scanty.  Hot  stage  followed  by  free 
perspiration;  decline  of  fever;  increase  of  urine. 

Scarlet  Fever. — ^Vomiting  or  convulsions;  may  be  a chill;  high 
fever;  rapid  pulse;  heavily  coated,  then  bright  red,  swollen  tongue; 
throat  red,  sore;  swallowing  painful;  glands  enlarged;  great  thirst; 


TEMPEEAMENTS,  CONSTITUTION,  AND  SYMPTOMS.  145 

scanty  urine;  fine,  diffuse,  red  rash  first  on  neck  and  chest;  lasting 
five  to  seven  days,  and  disappearing  momentarily  on  pressure;  erup- 
tion leaves  branny  scales;  great  restlessness,  sleeplessness,  headache, 
often  convulsions. 

Typhoid  Fever. — Gradual  onset  with  headache,  debility,  vague 
pains,  nosebleed,  may  be  slight  diarrhoea,  loss  of  appetite,  then  gradual 
rise  of  temperature,  lower  mornings,  higher  evenings;  abdomen  swollen 
and  tender ; with  rose-colored  spots  on  abdomen  seventh  to  ninth  day ; 
spots  disappear  on  pressure;  gurgling  in  abdomen;  pea  soup  diar 
rhoea;  tongue  becomes  dry,  brown;  teeth  and  lips  covered  with  sticky 
deposit;  delirium  or  stupor;  bleeding  from  bowels;  picking  at  bed 
clothes. 

k:  Typhus  Fever. — Sudden  pain  in  head,  back  and  legs;  extreme 
prostration;  fever  reaching  104  to  105°  in  from  two  to  three  days, 
and  remaining  high  about  two  weeks;  rapid,  weak  pulse;  musty  odor ; 
face  livid  and  dull;  pupils  of  eyes  contracted;  coarse,  mulberry 
rash  fourth  or  fifth  day  on  trunk  and  extremities;  urine  scanty; 
marked  nervous  symptoms;  bowels  constipated. 

Yellow  Fever. — Chill,  pain  in  head,  back  and  limbs;  rapidly  ris- 
ing fever;  vomiting;  thirst;  constipation;  then  remission  of  symp- 
toms for  six  hours,  followed  by  their  acute  return;  jaundice  of  skin; 
black  vomit;  bleeding  from  mouth,  bladder,  etc. ; scanty  or  suppressed 
urine;  great  prostration;  collapse  and  death  or  slow  convalescence. 

Smallpox. — Chill  or  series  of  chills,  followed  by  vomiting  and 
intense  pain  in  small  of  back;  rapidly  increasing  fever,  falling  the 
third  or  fourth  day;  rising  again  seventh  or  eighth  day;  pulse  full, 
rapid;  skin  dry;  breathing  hurried;  red  spots  first  on  forehead, 
face  and  wrists  having  hard,  shot-like  feel;  skin  between  is  swollen; 
soft,  yellow,  offensive  crusts;  spots  may  run  together  or  black  and 
blue  spots  form. 

Rheumatic  Fever. — Sudden  reddening,  swelling  and  tenderness 
of  one  of  the  large  joints,  with  intense  pain;  sudden  shifting  of  symp- 
toms to  another  joint;  moderately  high  fever;  rapid,  bounding 
pulse;  scanty  urine;  no  appetite;  constipation;  heavily  coated 
tongue. 

Cholera,  Asiatic. — ^Vomiting  alternating  with  painless  diarrhoea; 
frequent,  sudden  rice-water  movements  from  bowels;  excruciating 
cramps  in  calves  of  legs,  thighs,  arms,  and  abdomen;  face  pinched, 
blue,  sunken;  cold,  clammy  sweat;  pulse  thready,  weak;  breath  cool; 
voice  husky;  collapse  and  stupor. 

Inflammation  of  5pinal  Cord,  Acute. — Moderate  fever;  loss  of 
appetite;  coated  tongue;  constipation;  followed  by  radiating  pains 
from  back  to  limbs,  with  numbness,  tingling  or  burning;  pain  about 
waist;  loss  of  motion  of  limbs  and  increasing  paralysis. 


146 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 


Spotted  Fever.  Epidemic  Cerebrospinal  Meningitis. — Sudden  on- 
set; chill  followed  by  fever;  nausea;  great  thirst;  vomiting;  severe, 
continuous  headaches;  painful  stiffness  and  retraction  of  muscles 
of  the  neck;  dusky  mottling  of  the  skin. 

Measles. — Sneezing;  hoarseness;  cough;  running  from  eyes  and 
nose;  eyes  red  and  sensitive  to  light;  moderate  fever;  eruption  of 
small  pale  or  dark  red  velvety  spots  on  face,  then  on  trunk  and 
extremities,  with  itching  and  burning;  eruption  lasts  four  days  to 
a week. 

Heart. 

Weak  Heart. — Palpitation,  with  feeling  of  oppression  about  chest; 
fluttering,  irregular  pulse;  headache;  dizziness;  bloodlessness;  de- 
bility; indigestion. 

Enlargement  of  the  Heart.  Hypertrophy. — When  excessive  there 
may  be  weight  and  discomfort  in  the  chest;  bulging  of  chest  wall; 
a heaving  impulse  of  heart  against  chest;  shortness  of  breath;  head- 
ache; vertigo;  ringing  in  the  ears;  paroxysmal  cough;  palpitation; 
indigestion;  sleeplessness. 

Neuralgia  of  the  Heart.  Angina  Pectoris. — Sudden  attacks  of 
excruciating  pain  in  the  heart,  with  horrible  sense  of  suffocation; 
face  pale  and  cold;  pulse  variable,  often  weak  and  irregular;  pain 
in  left  shoulder;  attack  passes  off  with  belching  of  gas. 

Inflammation  of  the  Heart. — Pain  in  region  of  the  heart,  sense 
of  oppression;  anxiety;  difficult  breathing;  fever;  slight  cough;  head- 
ache; vertigo;  may  be  nausea;  irregular  action  of  heart;  palpitation. 

Headache. 

Chlorosis.  Green  Sickness. — Impoverished  blood  at  puberty; 
greenish  pallor  of  skin;  oalpitation;  indigestion;  nosebleed;  irri- 
tability; appetite  for  chalk,  slate  pencils,  etc.  : debility. 

Brain  Fever. — Intense  headache ; vertigo;  intolerance  to  light  and 
sound;  restlessness;  heat  in  head;  eyes  bloodshot ; fever;  later,  drow- 
siness and  inclination  to  vomit;  convulsions  in  children;  rapid,  feeble 
pulse. 

Insensibility. 

Epilepsy. — Peculiar,  premonitory  sensation  beginning  in  finger 
or  toe,  followed  by  sharp  cry,  and  sudden  fall  to  the  floor,  with  partial 
or  complete  loss  of  consciousness,  frothing  at  mouth;  biting  of  the 
tongue;  clenching  of  fingers;  face  becomes  bluish;  pupils  dilated; 
stupor  for  a varying  period  follows,  or  immediate  consciousness 
with  soreness,  weakness  and  mental  confusion. 

Hysteria. — Convulsive  seizures  simulating  epilepsy,  but  patient 
generally  fa, Us  in  a comfortable  place;  is  only  apparently  unconscious; 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS.  147 

screams,  cries,  or  laughs;  urine  often  retained;  sensation  of  ball  in 
the  throat;  headache  as  of  nail  in  the  head;  may  be  partial  paralysis, 
or  legs  and  arms  thrown  wildly  about. 

Apoplexy. — Patient  suddenly  falls  unconscious;  face  flushed; 
breathing  labored;  pulse  full  and  slow;  paralysis  on  one  side;  tongue 
protruded;  may  be  convulsions,  and  involuntary  passage  of  urine 
and  feces. 

Catalepsy.  Trance. — Patient  apparently  insensible;  lies  quiet; 
limbs  remain  in  any  position  they  are  placed;  muscles  stiff  and 
unyielding. 

Sunstroke. — Weakness,  dizziness  and  faintness  after  exposure 
to  heat,  or  partial  or  complete  unconsciousness;  pallor  of  face;  cold 
sweat;  shallow,  hurried  breathing;  or  dry,  burning  skin;  face  and 
eyes  congested;  pulse  full  and  rapid;  pupils  contracted;  stupor;  a 
dangerous  form. 

Paralysis. — Attack  preceded  by  numbness,  coldness,  paleness, 
and  slight  convulsive  jerking  or  twitching,  followed  by  loss  of  motion 
partial  or  complete,  and  of  upper  or  lower  half  of  body,  or  one  or 
both  sides;  may  be  loss  of  speech  and  other  faculties. 

Lungs. 

Bleeding  from  the  Lungs. — May  be  preceded  by  cough,  difficult 
breathing,  warmth  or  tenderness  in  chest,  salty  taste  in  mouth; 
blood  may  gush  up  or  be  coughed  up,  vdll  be  bright  red,  fluid,  and 
frothy,  and  taste  sweetish  or  salty. 

Pneumonia.  Lung  Fever. — Sudden  hard  chill  and  sharp  pain 
in  the’ side,  with  sharp  rise  of  temperature,  generally  falling  suddenly 
to  normal  the  fifth,  seventh  or  ninth  day;  shallow,  very  rapid,  diffi- 
cult breathing;  short,  dry,  hard  cough,  later  with  blood-streaked, 
rusty  expectoration,  becoming  free  and  like  prune  juice;  pain  in  chest; 
no  appetite;  tongue  coated;  thirst,  scanty  urine;  congestion  and 
consolidation  of  lungs;  may  be  typhoid  symptoms. 

Consumption.  Pulmonary  Tuberculosis. — Fatigue  and  short  breath 
on  slight  exertion;  loss  of  appetite;  imperfect  digestion;  paleness, 
with  hectic  flush  over  cheek  bones;  irregular  fever;  hacking  cough, 
at  first  dry,  later  with  increasing  expectoration;  night  sweats; 
loss  of  weight;  bleeding  from  lungs;  may  be  diarrhoea;  tubercle 
bacillus  in  expectoration;  contraction  of  chest;  swelling  of  feet. 

Nose. 

Hay  Fever. — Great  susceptibility  to  pollen  of  rag  weed,  hay, 
roses,  etc.;  redness  of  eyes,  swelling  of  eyelids;  sneezing;  running 
from  eyes  and  nose;  obstruction  of  nose;  headache;  cough;  may 
be  asthma. 


148  TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 

Catarrh,  Chronic  Nasal. — Mucous  or  partly  mucous,  partly  puru- 
lent discharge  from  nose,  obstruction  of  nostrils;  mouth  breathing; 
nasal  voice;  headache  in  forehead;  dropping  of  secretions  into 
throat;  frequent  hawking;  may  be  deafness  and  loss  of  taste  or 
smell. 

Pain. 

Inflammation  of  the  Liver. — Drawing  sensation  on  the  right  side 
in  region  of  the  liver;  slight  chill;  fever;  headache;  indigestion; 
loss  of  appetite;  may  be  nausea  and  vomiting;  slight  jaundice;  scant 
urine;  sometimes  hiccough;  weakness;  loss  of  flesh. 

Lockjaw.  Tetanus. — Painful,  increasing  stiffness  of  the  head, 
neck,  and  pain  extending  to  back,  abdomen  and  extremities;  corners 
of  mouth  drawn  upward;  jaws  tightly  closed;  body  convulsively 
arched  or  rigidly  straight;  slightest  touch  causes  spasm  with  great 
pain. 

Pleurisy. — Sharp,  stabbing  pain  in  the  side,  worse  on  deep  breath- 
ing and  motion;  breathing  feeble,  shallow  and  rapid;  slight,  irrita- 
tive cough;  scanty,  frothy  expectoration;  may  be  effusion  of  fluid 
into  covering  of  lungs,  with  chills,  fever,  sweats  and  emaciation. 

Gout. — Restlessness;  wakefulness;  irritability;  dyspepsia;  scanty, 
high-colored  urine;  agonizing  pain  and  tenderness  in  ball  of  great 
toe;  toe  reddish  purple  and  glazed;  veins  enlarged;  in  chronic  gout 
joints  enlarged,  deformed,  chalky,  stiff,  may  ulcerate. 

Gall  Stone  Colic. — Passage  of  gall  stones  causes  sudden,  agonizing, 
cutting,  tearing  or  shooting  pain  on  the  right  side  of  abdomen,  spread- 
ing to  right  side  of  chest  and  shoulder;  muscles  of  abdomen  cramped 
and  tender;  nausea;  vomiting;  profuse  sweat;  frequent  urination; 
pale,  distorted,  anxious  face  ; feeble  pulses. 

Painter’s  Colic. — Violent,  painful  contractions  of  the  abdominal 
muscles;  hollowing  in  of  the  abdomen;  obstinate  constipation;  grip- 
ing, cutting  pains;  may  be  blue  line  around  the  gums. 

White  Swelling.  Tubercular  Arthritis. — Dull  pain  in  joints, 
worse  by  motion  or  jarring;  tenderness  on  pressure;  more  or  less 
swelling  and  exudation  of  fluid ; wasting  of  muscles  above  and  below ; 
skin  white  and  shiny. 

Sciatica. — Sharp,  shooting  pain  running  down  the  back  of  thigh; 
worse  from  motion;  may  be  tingling  and  numbness,  and  nerves  sensi- 
tive to  touch;  worse  at  night  and  in  stormy  weather. 

Stone  in  the  Kidneys. — Constant  dull  pain  in  the  loin;  on  passage 
of  stone,  excruciating  paroxysm  of  pain  radiating  into  groin  and 
bladder;  numbness  of  thigh;  nausea;  vomiting;  sweat;  rapid  pulse; 
sufferer  may  faint. 


TEMPEK AMENTS,  CONSTITUTION,  AND  SYMPTOMS.  149 

Inflammation  of  the  Testicles.  Orchitis. — Drawing,  stretching 
pains  from  abdomen  through  spermatic  cords  and  testicles;  testicles 
swollen,  sensitive,  with  soreness  and  tearing  pains;  drawing  up  of 
testicles,  burning  and  difficulty  in  urinating. 

Writer’s  Cramp. — Fatigue,  weight  or  actual  pain  in  muscles  of 
hand;  spasm  of  muscles  when  fingers  grasp  a pen;  hand  may  tremble 
or  neuralgic  pain  occur. 

Hip  Joint  Disease. — Slight  lameness;  stiffness  of  muscles  about 
the  joint;  progressive  wasting  of  muscles  of  thigh;  limping,  with 
shortening  of  leg;  more  or  less  fluid  in  joint,  and  restriction  of  motion; 
formation  of  abscess,  with  pain  and  tenderness;  deformity  of  hip. 

Poisoning. 

Arsenic  Poisoning. — Burning  in  stomach  and  bowels;  cramps  in 
abdomen  and  legs;  vomiting  followed  by  diarrhoea;  rice-water  stools 
which  are  bloody. 

Lead  Poisoning. — Obstinate  constipation;  abdominal  colic;  wrist 
drop;  blue  line  about  the  gums;  cramps  in  the  legs;  pains  in  the 
joints;  trembling  of  extremities;  intense  headache;  may  be  convul- 
sions, delirium  and  lethargy. 


Skin. 

Eczema.  Salt  Rheum. — Inflammation  of  skin,  with  watery  pimples 
or  pustules  forming  scales  and  crusts;  itching;  burning;  watery  or 
yellow  sticky  discharge,  or  oozing;  raw  surface  beneath  crusts;  or 
dry,  scaly  patches,  without  itching. 

Itch.  Scabies. — ^Small  pimples  first  appearing  between  fingers, 
in  creases  of  wrists,  groin,  armpit,  under  the  breasts,  on  inner  side 
of  thighs,  with  intense  itching. 

Ringworm  of  the  5calp. — Small,  separate,  round  or  irregularly 
shaped,  reddened  scaly  patches,  turning  to  little  vesicles  filled  with 
matter,  which  dry  up  and  scale  off;  hair  dead  and  brittle;  patches 
spread  rapidly. 

Shingles.  Herpes  Zoster. — Pin  head  to  pea-sized  watery  pimples 
along  a nerve,  preceded,  accompanied  or  followed  by  neuralgic  pains 
in  affected  part;  one  side  of  body  only;  fluid  dries  up,  and  yellow- 
brown  crusts  form  and  drop  off. 

Nettle  Rash.  Urticaria. — Skin  shows  pale  red  elevations,  itching 
intensely;  finger  drawn  over  surface  causes  white  line  which  becomes 
elevated  and  red;  eruption  on  covered  parts  of  body  especially. 

Boil. — Small,  limited,  painful  tumor  beginning  as  a sore,  itching 
pimple,  developing  a core  of  dead  tissue,  and  suppurating. 


150  TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 

Carbuncle. — Dark  red,  painful,  circumscribed,  flattened  swelling, 
surrounded  by  dusky-red  skin,  appearing  on  neck,  back  or  buttocks, 
suppurating  in  a week  or  ten  days,  and  discharging  through  several 
openings. 

Cancer  of  the  Skin.  Epithelioma. — In  the  beginning  a few  greasy 
scales  or  papery  crust  covering  three  or  four  shallow  irregular  ulcers 
with  hard  margin;  or  may  be  deep-seated,  shiny,  hard,  red  lump, 
changing  to  ulcer  with  blood-stained  yellow  fluid,  or  offensive  sticky 
discharge;  sharp,  shooting  pains. 

Blackheads.  Acne. — Small  pimples  on  face,  chest,  shoulders, 
back,  neck;  moist  or  dry;  reddish  or  black;  with  or  without  indiges- 
tion, debility,  menstrual  disorders;  may  contain  matter  or  cheesy 
substance. 

Warts. — Pinhead  to  bean-sized,  limited  elevation  of  the  skin; 
some  soft,  red,  dry  or  moist;  bleed  easily;  some  soft  and  pearly; 
others  hard,  black,  flat  or  rounded. 

Gangrene.  Mortification. — In  dry  form,  skin  pale,  dry,  shriveled, 
semi-translucent,  with  bluish-mottled  specks  becoming  dark,  opaque, 
mummified;  in  moist  form,  congestion  of  part;  skin  dark,  livid, 
moist;  tissues  soften  and  break  down;  foul  odor. 

Ulcers. — Sore  on  leg  or  elsewhere,  red,  inflamed,  irritable,  with 
painful,  ragged  edge;  or  varicose  ulcer  with  much  distention  of  nearby 
veins;  or  syphilitic  ulcer  with  punched-out  looking  sore,  and  offen- 
sive discharge. 

Milk  Crust. — Small  pimples  form  on  face  or  scalp  of  infants  and 
children,  with  redness  and  itching;  pimples  rupture  and  exude  a 
sticky  fluid  forming  yellow  crust,  with  raw  surface  underneath. 

Scurvy.— Great  debility;  bloodlessness;  spongy,  bleeding  gums, 
with  foul  breath;  teeth  loosened;  pain  in  legs;  skin  dry  and  rough; 
flesh  brawny  and  hard;  complexion  shallow;  bleeding  from  mouth, 
bladder,  etc.;  short  breath;  feeble  pulse. 

Erysipelas. — Slight  fever,  chilliness,  tingling  of  affected  part, 
which  becomes  glossy,  bright  red  or  brawny,  swollen,  hard,  sharply 
defined;  fever  increases;  pulse  full,  rapid;  appetite  lost;  bowels  con- 
stipated; tongue  coated;  small  pimples  form;  inflammation  spreads 
or  begins  to  subside  in  four  or  five  days. 

Swelling. 

Scrofula. — Swelling  and  suppuration  of  glands  of  neck,  groin 
and  under  the  arms;  sometimes  slight  fever,  debility,  emaciation; 
free  perspiration,  especially  about  the  head. 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS.  151 

Goitre. — Usually  non-painful,  non-tender  swelling  of  varying 
size  of  thyroid  gland  in  neck;  when  large,  causing  difficult  breathing, 
headache,  flushed  face;  may  be  shooting  pains. 

Dropsy. — Swelling  of  feet,  hands,  legs,  abdomen  or  chest  in  lung, 
liver,  kidney  or  heart  disease;  swelling  and  paleness  of  skin;  sur- 
face hard  and  pitting  on  pressure  of  finger. 

Goitre,  Exophthalmic. — Debility  and  bloodlessness;  enlargement 
of  thyroid  gland;  protrusion  and  staring  appearance  of  eyes;  palpi- 
tation; pulse  beats  100°  to  140°  a minute;  blowing  sound  over  gland. 

Stomach. 

Dyspepsia,  Nervous. — Tongue  often  clean,  appetite  very  variable, 
may  crave  acids,  slate  pencils,  etc.;  headache;  vertigo;  irritability; 
depression;  sleeplessness  or  bad  dreams;  lassitude;  palpitation; 
lump  in  the  chest. 

Dyspepsia,  Catarrhal. — Loss  of  appetite;  sense  of  fullness  and 
discomfort;  eructations;  nausea  and  sometimes  vomiting;  tongue 
heavily  coated;  mucus  in  vomitus  and  stools;  may  be  diarrhoea; 
hiccough;  heartburn. 

Bleeding  from  the  Stomach. — Usually  occurs  with  vomiting  and 
is  provoked  by  taking  food;  blood  is  dark,  clotted,  and  generally  mixed 
with  contents  of  stomach. 

Neuralgia  of  the  Stomach. — Intense,  griping,  agonizing  pain  in 
stomach  usually  extending  to  the  back,  with  belching  of  gas,  faint- 
ness, and  intermittent  pulse;  symptoms  partially  relieved  by  pres- 
sure over  stomach. 

Cancer  of  the  Stomach. — Indigestion;  great  acidity;  flatulence; 
loss  of  appetite;  foul  breath;  great  debility;  emaciation;  vomit- 
ing; coffee-ground  vomit  from  retained  blood;  pain,  more  or  less 
continuous. 

Colic  in  Infants. — Sudden  paroxysms  of  spasmodic  crying  often 
waking  child  from  sleep;  jerking  of  the  feet;  clenching  of  the  hands; 
sudden  drawing  up,  then  straightening  of  the  legs;  flatulence;  dis- 
tention or  retraction  of  the  abdomen;  contortions  of  whole  body. 

Sores. 

Syphilis.  First  Stage. — Within  a month  of  exposure,  small,  red 
sore  appears  on  genitals,  which  enlarges  and  breaks  in  centre,  leaving 
ulcer;  nearby  glands  enlarge  and  become  hard;  may  be  no  impair- 
ment of  general  health. 

Syphilis.  Second  Stage. — Within  six' or  eight  weeks,  sore  throat; 
moderate  fever;  languor;  headache;  bone  pains;  indigestion;  ulcers 


152 


TEMPERAMENTS,  CONSTITUTION,  AND  SYMPTOMS. 


on  throat  or  tonsils;  dull  copper-hued  eruption  on  abdomen,  chest, 
arms,  shoulders,  genitals. 

Syphilis.  Third  Stage. — Within  one  or  many  years,  pustules  on 
body  which  form  deep  ulcers,  with  dry  crusts  and  scales;  loathsome 
sores  leaving  bad  scars;  ulceration  of  throat,  palate,  nose;  hard 
lumps  in  muscles  and  under  skin. 

Abscess. — Localized  inflammation,  with  heat,  swelling,  pain, 
formation  of  pus,  tendency  to  point  and  discharge  matter. 


Throat. 

Tonsilitis. — Tonsils  swollen;  difficulty  in  swallowing  and  much 
pain;  often  cheesy  spots  or  patches  on  tonsils  and  throat;  dribbling 
of  saliva;  fever;  headache. 

Enlarged  Tonsils. — Tonsils  too  large;  may  contain  minute  cavi- 
ties containing  foul,  cheesy  matter;  mouth  breathing,  difficult  swal- 
lowing; snoring  during  sleep;  mental  dullness;  night  terrors;  deaf- 
ness; bad  breath;  thick  voice. 

Quinsy.— Tonsilitis  symptoms,  together  with  inflammation  of 
deeper  tissues;  chills;  high  fever;  swelling  of  glands  of  neck;  sup- 
puration, and  formation  of  tonsilar  abscess,  with  tendency  to  point 
and  discharge. 

Croup,  Spasmodic. — Hoarseness  and  slight  cough  during  day; 
sudden  awakening  at  night  by  severe  paroxysm  of  suffocative, 
hard,  barking  cough;  skin  hot;  pulse  tense  and  rapid;  perspiration. 

Pharyngitis. — Soreness  of  back  of  mouth  and  throat;  pain  on 
swallowing  or  difficult  swallowing;  coating  of  glairy  mucus  on  roof  of 
mouth,  tonsils  and  throat;  some  fever;  swelling  of  affected  parts. 

Diphtheria. — Chills,  moderate  fever,  sore  throat,  indisposition, 
followed  by  stiffness  and  swelling  of  glands  of  neck;  grayish  white 
membrane  in  throat,  removal  of  which  causes  bleeding;  weak  pulse, 
scanty  urine;  detection  of  Klebs-Loffler  bacillus. 

Thrush. — Swollen,  red,  spongy  gums;  flaky,  white  deposits  of 
lining  membrane  of  mouth,  leaving  bleeding  spots  when  removed; 
fever;  pain  in  mouth;  mouth  waters;  bad  breath. 

Urine. 

Incontinence  of  Urine.  Enuresis. — Profuse  involuntary  flow  of 
pale,  watery  urine;  constant  dribbling  of  urine  while  sitting  or  walk- 
ing; dribbling  of  scanty,  high  colored  urine;  wetting  the  bed  at 
night. 


TEMPfiRAMlfiN'TS,  CONSTITUTION,  AND  SYMPTOMS  153 

Retention  of  Urine.  Strangury. — Urine  passed  drop  by  drop,  with 
much  urging  and  straining;  pain  and  heat  along  the  urethra:  diffi- 
cult, scanty  urination. 

Stone  in  the  Bladder. — Irritation  and  inflammation  of  bladder; 
frequent  burning  discharge  of  small  amounts  of  urine,  with  urging; 
acute  pain  on  passage  of  stone,  with  bloody  urine;  sudden  stoppage 
of  stream  of’ urine. 

Inflammation  of  the  Bladder.  Cystitis. — May  begin  with  chilliness 
and  fever,  then  constant  dull  ache,  or  sharp  agonizing  pain  in  bladder ; 
frequent  lU’ging  to  urinate,  with  burning  pain  on  urinating;  pus  in 
the  urine. 

Diabetes  Mellitus. — Gradual  failure  of  health;  frequent  and  ex- 
cessive urination  of  pale  urine,  loaded  with  sugar;  great  thirst  and 
emaciation;  large  appetite;  constipation  or  exhausting  diarrhoea; 
skin,  mouth  and  throat  dry;  itching  of  skin;  teeth  decay;  failure  of 
sexual  powers. 

Jaundice. — Yellowishness  of  the  skin,  white  of  eyes,  inside  of 
mouth  and  of  urine  and  feces;  stools  light  colored;  urine  dark;  may 
be  itching  of  the  skin;  mental  depression;  delirium,  convulsions, 
and  stupor  in  bad  cases. 

Inflammation  of  Urethra.  Gonorrhea. — Burning  heat,  tenderness 
and  puffiness  at  entrance  of  urethra;  catarrhal  discharge,  soon  turn- 
ing to  thick,  purulent  matter;  frequent,  painful  erections;  urine 
passed  in  spurts,  drops  or  twisted  stream. 

Dropsy  of  the  Abdomen. — Sensation  of  weight  in  the  abdomen; 
distention;  difficult  breathing;  scanty  urine;  swelling  of  the  feet; 
constipation;  fluctuation  of  fluid  on  pressure. 

Worms. 

Worms. — Loss  of  appetite  or  ravenous  hunger;  disturbed  sleep; 
great  restlessness;  picking  at  the  nose;  bad  breath;  lassitude;  dark 
circles  round  eyes,  indigestion;  straining  at  stool;  itching  of  anus; 
grinding  of  teeth  in  sleep;  may  be  colicky  pains. 

Tape  Worm. — May  be  no  symptoms,  or  may  be  indigestion; 
mucous  stools;  colicky  pains;  voracious  appetite;  debility;  night  ter- 
rors; intense  itching  of  nose  and  genitals;  twitching  of  muscles; 
convulsions. 


SKIN  DISEASES 


The  Skin  Magnified 


1.  Pores  of  Skin.  2.  Outer  layer  of  Skin  or  Cuticle.  3.  Dermis  or  upper  layer  of  true  Skin. 
4.  Under  layer  of  true  Skin.  5.  Nerve  Prolongations.  6.  Blood  Vessels.  7.  Sweat  glands  sur- 
rounded by  cells  of  fat.  8.  Glands  or  cells  of  fat. 


Skin  of  the  back  of  the  hand  showing  pores, 
glands  and  hair  (magnified) . 


Skin  of  the  palm  of  the  hand  magnified  1000 
times,  showing  pores  through  v^hich  sweat 
passes. 


156 


SKIir  DISEASES. 


Such  as  are  distinguished  by  inflammation  of  the  derma,  without 
constitutional  symptoms  of  a specific  hind. 

Congestive  Inflammation  of  the  True  Skin. 

The  First  of  these  Groups, — those  characterized  by  inflammation 
of  the  cutis,  with  constitutional  symptoms  of  a specific  hind, — embraces 
measles,  scarlet  fever,  varioloid,  and  cow-pox. 

Measles.  — Rubeola. 

Measles  is  an  acute  inflammation  of  the  entire  skin,  both  external 
and  internal,  associated  with  an  infectious  and  contagious  fever. 

Symptoms. — The  disease  sets  in  with  chills,  succeeded  by  burning 
heat,  listlessness,  languor,  drowsiness  ; pains  in  the  head,  back,  and 
limbs  ; frequent  pulse  ; soreness  of  the  throat ; thirst,  nausea,  vomit- 
ing, frequent  dry  cough  and  high-colored  urine.  These  symptoms 
increase  in  violence  for  four  days.  On  the  third  day  the  eyes  become 
inflamed,  cannot  bear  the  light,  and  pour  fourth  a profusion  of  tears. 
This  last  symptom  is  called  coryza.  The  nose  likewise  discharges  a 
large  quantity  of  watery  secretion,  and  sneezing  is  frequent.  The 
larynx,  windpipe,  and  bronchial  tubes  become  inflamed,  and  hoarse- 
ness, soreness  of  the  breast,  etc.,  are  the  result. 

The  redness  of  the  skin  and  breaking  out  appear  about  the  fourth 
day,  and  produce  heat  and  itching.  This  breaking  out  is  character- 
ized by  a patchy  redness,  wliich,  on  close  inspection,  is  found  to  con- 
sist of  numberless  minute  red  points  and  pimples,  collected  into 
patches  in  the  shape  of  a half  or  quarter  moon.  They  appear  first  on 
the  forehead  and  front  of  the  neck,  then  upon  the  cheeks  and  around 
the  nose  and  mouth.  On  the  fifth  day  they  reach  their  height  in  this 
region,  and  then  appear  upon  the  body  and  arms,  and  on  the  sixth 
day,  upon  the  legs.  The  color  of  the  skin,  when  the  inflammation  is 
at  its  height,  is  of  a bright  raspberry  red.  The  decline  of  the  rash 
takes  place  in  the  same  order  in  which  it  comes  out.  The  redness 
fades  on  the  sixth  day  upon  the  face ; on  the  seventh,  upon  the  body 
and  limbs ; on  the  eighth,  upon  the  back  of  the  hands.  The  coryza, 
the  hoarseness,  and  the  cough,  decline  about  the  seventh  day,  while 
a diarrhoea  comes  on  about  the  eighth  or  tenth,  — showing  that  the  in- 
flammation of  the  mucous  membrane  is  subsiding.  When  the  inflam- 
mation disappears,  the  whole  scarf-skin  peels  off  in  the  form  of  a 
scaly  scurf.  The  artist  has  given  a good  picture  of  the  disease  in  the 
beautifully  colored  lithograph,  Plate  I,  Fig.  1. 

Treatment. — When  the  disease  is  mild  and  regular  in  its  course, 
scarcely  anything  will  be  required,  except  mild  diet,  slightly  acid 
drinks,  with  flax-seed  tea,  slippery  elm,  or  some  equivalent,  to  quiet 
the  cough.  Sponging  with  tepid  water,  if  done  with  frequency,  mod- 
erates the  fever,  and  adds  to  the  comfort  of  the  patient.  If  the  fever 


'4-' 


. ■ >■;;  'V-  ■ 


•-  I * >: 


m-  - 

■i,.;''‘j>?4>  V‘i 


fr\' 


vv:; 

'■'  -t 


/'■  •. 


^'.  .WiiM.  - .... 


SKIN  DISEASES. 


157 


runs  high,  take  half  an  ounce  of  rochelle  salt,  and  use  recipe  125. 
Should  the  eruption  “ strike  in,”  apply  leeches  or  cups  over  the  in- 
ternal organ  affected,  if  any,  and  recall  the  rash  by  sweating. 

Those  who  have  been  exposed  to  the  contagion,  and  are  liable  to 
have  the  disease,  should  avoid  all  unnecessary  exposure  to  wet  or 
cold,  — keeping  the  feet  warm  and  dry,  and  the  whole  body  well  clad. 
With  these  precautions,  and  a mild,  unstimulating  diet,  much  of  the 
force  of  the  disease  may  be  broken. 

During  the  first  stages  of  the  disease  if  the  onset  has  not  been 
stormy  nothing  further  will  be  necessary  than  the  precautions  already 
advised.  Should,  however,  the  rash  be  delayed  or  appear  in  patches 
over  the  body,  the  patient  should  be  given  a full  bath  of  either  hot 
water  or  hot  water  with  the  addition  of  mustard  in  the  proportion  of 
two  teaspoonfuls  to  the  gallon.  The  employment  of  hot  drinks  should 
be  limited  to  saffron  tea  or  hot  lemonade,  as  we  use  care  not  to  add 
to  the  existing  high  fever  which  usually  is  present  when  the  eruption 
is  slow  in  appearing. 

Besides  the  milder  forms  of  the  disease,  cases  occur,  chiefly  in 
broken-down  constitutions,  in  which  the  rash  delays  its  coming  out 
till  the  seventh  day,  and  is  then  mingled  with  dark  and  livid  spots, 
which  remain,  often,  for  ten  or  twelve  days.  The  fever  is  of  a low, 
typhoid  kind,  and  the  patient  is  extremely  weak  and  languid. 

In  this  condition  of  things,  the  patient  must  be  supported  by  tonics 
(77  and  59),  and  whisky,  and  expectoration  promoted  by  some  appro- 
priate remedy,  if  required. 

If  at  any  stage  of  the  disease  there  should  be  fixed  pain  in  any 
part  of  the  chest,  which  is  made  worse  by  coughing,  or  by  taking  a 
full  breath,  we  may  conclude  there  is  some  inflammation  of  the 
chest. 

The  seriousness  of  this  complication  will  be  understood  from  the 
fact  that  the  bronchitis  has  now  extended  and  small  patches  of  in- 
flammation known  as  broncho-pneumonia  have  appeared.  Medicines 
to  enable  the  patient  to  raise  the  phlegm  easier,  such  as  five  grains  of 
chloride  of  ammonia  in  two  tablespoonfuls  of  sweetened  water  or 
simple  syrup  may  be  given  every  three  hours,  and  1-80  of  a grain  of 
sulphate  of  strychnia  to  support  the  heart,  in  addition  to  the  other 
treatment  given  under  the  heading  '‘broncho-pneumonia.” 

Scarlet  Fever.  — Scarlatina. 

This  is  likewise  an  acute  inflammation  of  the  entire  covering  of 
the  body,  both  external  and  internal,  connected  with  fever  which  is 
infectious  and  contagious. 

Symptoms. — The  fever  comes  on  somewhere  between  the  second 
and  tenth  day  after  exposure.  On  the  second  day  of  the  fever,  the 
eruption  comes  out  in  the  form  of  very  small  points  and  pimples, 
which  appear  either  in  patches,  or  constitute  a general  redness,  of  a 
hrigJit  scarlet  color.  In  Plate  I,  Fig.  2,  the  artist  has  given  a fine 
picture  of  the  disease. 


158 


SKIN-  DISEASES. 


The  disease  begins  with  languor,  pains  in  the  head,  back,  and  limbs, 
with  drowsiness,  nausea,  and  chills ; and  these  are  followed  by  heat, 
thirst,  etc.  When  the  redness  appears,  the  pulse  is  quick,  and  the 
patient  is  anxious,  restless,  and  sometimes  delirious.  The  eyes  are 
red,  the  face  swollen,  the  tongue  covered  in  the  middle  with  white 
mucus,  and  is  studded  with  elevated  points  of  extreme  redness.  The 
tonsils  are  swelled,  and  the  throat  red.  The  greatest  degree  of  red- 
ness is  reached  on  the  evening  of  the  third  or  fourth  day  from  its  be- 
ginning, when  a gentle  moisture  appears,  the  disease  begins  to  decline, 
with  itching,  and  the  scarf-skin  falls  off  in  branny  scales. 

A swelling  or  puffiness  of  the  flesh,  which  spreads  out  the  Angers 
in  a singular  manner,  seems  to  be  peculiar  to  scarlet  fever. 

In  the  first  stage  of  the  complaint,  the  tongue,  as  stated  above,  is 
covered  with  a fur ; but  as  it  advances,  the  tongue  often  becomes 
suddenly  clean,  and  presents  a glossy,  fiery-red  surface,  which  is 
sometimes,  with  the  whole  lining  of  the  mouth,  raw  and  tender. 

It  is  peculiar  in  this  complaint,  that  the  inflammation  of  the 
throat  always  runs  into  a state  of  ulceration.  As  far  as  can  be 
seen,  on  pressing  down  the  tongue,  the  throat  is  swollen  and  of  a 
deep,  florid  red;  and  on  the  tonsils  may  be  seen  white  or  gray 
ulcers.  This  makes  swallowing  very  difficult,  and  aggravates  the 
sufferings  of  the  patient.  The  great  amount  of  mucus  in  these 
parts  causes  also  a continual  rattling  in  the  throat. 

In  quite  a large  number  of  cases  of  this  disease  the  usual  ulceration 
of  the  throat  is  replaced  by  an  attack  of  true  diphtheria,  which,  if 
at  all  severe,  will  require  the  giving  of  antitoxin  of  diphtheria  in 
addition  to  the  treatment  recommended  for  scarlet  fever. 

The  eustachian  tube,  which  extends  up  to  the  ear,  is  apt  to  get 
involved  in  the  inflammation,  and  cause  swelling  and  pain  in  that 

region.  The  glands  under  the  ear  and  jaw 
sometimes  inflame,  and  after  a time  they  oc- 
casionally break.  Abscesses  formed  in  the 
ear  frequently  produce  some  deafness  which 
is  not  easily  cured. 

In  the  cell-dropsy,  which  sometimes  appears 
after  scarlet  fever,  the  crystals  of  urate  of 
ammonia  may  often  be  found  in  the  urine 
with  the  microscope  (Fig.  72). 

This  disease  resembes  measles,  but  may 
Fig.  72.  be  distinguished  from  it  by  the  absence  of 

cough ; by  the  eruption  being  finer ^ and  of  a more  scarlet  color  (see 
plate) ; by  the  rash  coming  out  on  the  second  day  instead  of  the 
fourth  ; and  by  the  ulceration  in  the  throat. 

Treatment.  — In  ordinary  cases,  the  treatment  should  be  very 
simple.  The  apartment  should  be  kept  cool,  and  the  bed-covering 
light.  The  whole  body  should  he  sponged  with  cool  water  as  often  as 
it  is  hot  and  dry,  and  the  patient  be  permitted  to  take  cooling  drinks. 
Besides  this,  in  many  cases,  very  little  is  needed,  except  to  give  a 
few  drops  of  the  tincture  of  belladonna,  night  and  morning. 


SKIK  DISEASES. 


159 


The  cold  stage  having  passed,  and  the  fever  set  in,  warm  water 
may  be  used  without  the  mustard,  etc.  If  the  head  be  affected,  put 
mustard  drafts  upon  the  feet.  Should  the  bowels  be  costive,  they 
may  be  gently  opened  by  some  very  mild  physic. 

No  solid  food  should  be  allowed ; but  after  the  first  shock  of  the 
disease  is  passed,  drinks,  in  reasonable  quantities,  will  be  advisable, — 
such  as  cold  water,  lemonade,  barberry  and  tamarind  water,  rice 
water,  balm  or  flax-seed  tea,  and  some  thin  water-gruel. 

To  promote  the  action  of  the  skin,  the  spirits  of  nitre,  with  other 
articles  (125),  adapting  the  dose  to  a child,  will  be  found  useful. 

Muriatic  acid,  forty-five  drops  in  a tumbler  filled  with  water,  and 
sweetened,  and  given  to  a child  in  teaspoonful  doses,  is  a good  remedy. 

In  very  violent  attacks,  the  system  sometimes  inclines  to  sink  im- 
mediately ; typhoid  symptoms  show  themselves ; there  is  great  pros- 
tration ; the  eruption  strikes  in ; the  skin  changes  to  a purple  or 
mahogany  color ; the  tongue  is  of  a deep  red,  or  has  a dark-brown 
fur  upon  it,  and  the  ulcers  in  the  throat  become  putrid.  This  is 
called  scarlatina  maligna ; but  it  is  only  a severer  form  of  the  same 
disease.  . 

The  treatment  of  this  form  must  be  different  from  that  recom- 
mended above.  It  must  be  tonic.  Quinia  (65)  must  be  freely  given. 
Wine  whey,  mixed  with  toast-water,  will  be  useful.  Tincture  of 
cayenne,  in  sweetened  water,  may  be  given  often  in  small  doses. 
Ammonia  (135)  may  likewise  be  given  as  a stimulus.  Gargles  (245) 
(244)  (243)  are  also  required. 

A dropsical  affection  is  one  of  the  most  frequent  results  of  scarlet 
fever.  It  is  believed  that  this  seldom  occurs,  if  the  warm  bath  is 
daily  used,  as  soon  as  the  skin  begins  to  peel  off.  After  the  dropsy 
has  set  in,  give  the  warm  bath  twice  a week,  and  encourage  perspi- 
ration by  the  compound  tincture  of  Virginia  snake-root,  and  similar 
articles. 

In  young  children,  also  in  severe  cases  of  fever  or  where  the  kidneys 
are  not  working  properly  as  shown  by  swelling  of  the  face,  abdomen 
and  extremities,  milk  should  be  the  only  article  of  diet  allowed  until 
these  symptoms  have  quieted  down.  Should  the  stomach  reject  the 
milk,  you  may  add  lime  water,  a teaspoonful  to  a tumbler  of  milk. 
From  one  pint  to  two  quarts  of  milk  according  to  age  will  maintain 
the  nourishment  of  anyone  over  days  and  weeks  at  a time  and  gradu- 
ally the  different  broths,  as  chicken  or  lamb  and  beef  tea,  may  be  added, 
and  later  bread  and  butter,  boiled  custard,  rice  and  tapioca  puddings. 

Anointing  the  skin  with  vaseline  at  night  and  washing  off  in  the 
morning  with  suds  removes  the  poisonous  scales,  and  lessens  the 
danger  of  contagion,  as  well  as  improves  the  activity  of  the  skin. 
Nasal  and  aural  catarrhal  diseases  are  commonly  observed  to  follow 
scarlet  fever  and  need  attention  of  a physician.  Rheumatism  like- 
wise is  a frequent  sequela,  while  nephritis  or  inflammation  of  the 
kidneys  is  often  a sad  reminder  of  the  disease.  These  two  compli- 
cations are  to  be  treated  as  directed  elsewhere. 


160 


SKIN  DISEASES. 


TABLE  EXHIBITING  THE  DIFFERENCE  BETWEEN  SMALL-POX,  VARIO- 
LOID, SCARLET  FEVER  AND  MEASLES. 


SMALL-POX. 

First.  Period  between  exposure  and  when  dis- 
ease first  shows  itself  is  from  five  to  twenty  days  — 
usually  shows  itself  in  ten  or  tweive  days. 

Second.  The  fever  and  temperature  is  high,  but 
is  less  after  rash  appears. 

Third.  The  rash  appears  on  third  or  fourth  day 
and  is  seen  on  the  forehead  or  some  part  of  face. 

Fourth.  The  eruption  first  consists  of  pimples, 
then  watery  blisters  which  become  white  and  sink 
in  the  center. 

Fifth.  The  tongue  is  coated  and  swollen. 

Sixth.  The  eyes  do  not  rim,  and  bronchitis  does 
not  appear. 

Seventh.  Sore  throat  is  often  present  but  not  to 
as  great  an  extent  as  in  Scarlet  Fever.  Delirium 
and  convulsions  may  occur. 

Eighth.  Secondary  fever  appears  after  several 
days. 

Ninth.  There  are  apt  to  be  pocks  and  the  eye- 
sight be  weakened,  but  by  modern  treatment  it 
can  usually  be  avoided. 


SCARLET  FEVER. 

First.  Period  between  contagion  and  when  dis- 
ease first  shows  itself  is  usually  from  three  to  six 
days,  but  may  be  much  longer. 

Second.  Fever  greatly  increased  and  continues 
without  abatement  after  eruption  appears. 

Third.  Eruption  makes  its  appearance  on  sec- 
ond day  on  the  chest  and  neck  and  spreads  over 
the  body  during  the  next  twelve  hours. 

Fourth.  The  eruption  extends  over  the  entire 
skin. 

Fifth.  Eruption  lasts  from  six  to  seven  days 
when  it  begins  to  come  off  in  large  scales. 

Sixth.  Tongue  is  covered  with  little  red  points. 

Seventh.  There  is  little  trouble  with  bronchitis 
or  running  of  eyes. 

Eighth.  Sore  throat. 

Ninth.  The  mind  is  apt  to  be  affected  and  there 
may  be  delirium, 

'Tenth.  Usually  no  secondary  fever. 

Eleventh.  In  Scarlet  Fever  there  is  great  dan- 
ger of  the  patient  being  left  with  kidney  trouble, 
or  the  eyes,  ears,  or  throat  may  be  affected. 


VARIOLOID. 

First.  Period  of  incubation  more  irregulai 
than  Small-Pox  — from  five  to  twenty  days  — av- 
erages twelve  days. 

Second.  Fever  high  till  rash  is  well  developei 
and  then  a greater  improvement  than  in  Small 
Pox. 

Third.  Eruption  appears  on  third  or  fourtl 
day. 

Fourth.  Rash  consists  of  pimples,  may  go  oi 
to  pustules  and  blisters,  but  usually  subside  be 
fore  advancing  so  far. 

Fifth.  Tongue  coated  and  swollen. 

Sixth.  No  nose  or  eye  symptoms  as  a rule. 

Seventh.  Sore  throat  mild.  Delirium  and  sev 
erity  of  disease  often  marked  at  beginning  bul 
quickly  subside. 

Eighth.  Secondary  fever  less  marked  than  in 
Small- Pox. 

Ninth.  Instead  of  rapidly  convalescing,  the 
patient  often  shows  an  amount  of  weakness  and 
aniemia  all  out  of  proportion  to  preceding  symp- 
toms. 

MEASLES. 

First.  Period  between  exposure  and  when  dis- 
ease first  shows  itself  is  from  seven  to  fifteen 
days. 

Second.  There  is  a moderate  fever.  It  does 
not  decrease  but  increases  after  eruption. 

Third.  Eruption  appears  on  fourth  day  on 
face  and  spreads  over  rest  of  body  in  about  two 
days. 

Fourth.  Eruption  is  crescent-shaped,  rest  of 
skin  healthy. 

Fifth.  Eruption  lasts  about  five  days,  then 
peels  off  in  scales. 

Sixth.  Tongue  has  red  edges  and  is  coated. 

Seventh.  The  nose  and  eyes  run  and  bronchitis 
is  usually  apparent. 

Eighth.  Usually  throat  is  not  sore. 

Ninth.  The  mind  is  not  affected. 

Tenth.  The  fever  subsides  after  the  third  day 
and  there  is  no  secondary  fever. 

Eleventh.  The  patient’s  eyes  may  be  inflamed 
and  consumption  or  bronchitis  follow. 


Small^Pox.  - — Variola. 


This  is  another  disease  characterized  hy  acute  inflammation  of 
the  entire  skin,  both  external  and  internal,  connected  with  infectious 
and  contagious  fever.  The  eruption  has  the  form  of  red  points, 
which  soon  become  pimples,  then  vesicles,  then  flattened  and  scoojjed- 
out  vesicles,  then  pustules,  and  finally  hard  brown  scabs.  These  last 
fall  off  from  the  eleventh  to  the  twenty-fifth  day,  and  leave  behind 
them  small  pits  and  scars.  The  fever  is  remittent,  and  precedes  the 
eruption  some  three  or  four  days,  — ceasing  when  the  eruption  is 
developed,  and  returning  when  it  has  reached  its  height.  The 
period  between  exposure  and  the  attack  of  the  disease,  called  inevr 
hatiov,,  is  from  five  or  six  to  twenty  days, — being  short  iu  the  severe 
cases,  and  longer  in  the  milder  ones. 

Symptoms The  disease  begins  with  languor  and  lassitude,  with 

shivering,  and  pains  in  the  head  and  loins  ; with  hot  skin,  and  quick- 
ened pulse  and  breathing ; with  thirst,  loss  of  appetite,  and  furred 
tongue ; with  nausea,  vomiting,  constipation,  restlessness,  and  uni- 


SMALL  POX 


PI. 2. 


€ 


P.0  ^ 

'>  :j 


'3> 


(S 

fc.  ■ 

r ::-:-0:  ' 

m. 


C-: 


\ 

0 '■ 


0 ^ 


“ (:;< 

V 

..  c ^ o 

■■-  ‘-''  -L  oP 


C^'V 


(Ti 


V:-o 


•A. 


j}  ■ 


<p  k-/ 


Yoyress  of 
imaU  Pox. 


If^dcuj.  2'y^daA^.  3’'.^dMy.  5^^d(xy.  S^day.  l^f^day.  Tl^.^day. 


Progress  of 
'arioloid. 


nfday.  Z^dag.  3P^doy  A 


my. 


8^^cLay.  W^-^doiy. 


4^dag. 


d^^fday. 


H^.hdcnj. 


Idb'd.^y. 


'Ogress  of 
vcinMion. 


SKIN  DISEASES. 


161 


versal  prostration.  To  these  symptoms  sometimes  succeed  difficult 
breathing,  cough,  drowsiness,  and  even  insensibility.  The  tongue, 
white  at  first,  soon  becomes  red  at  the  point,  and  over  the  whole 
surface.  The  fever  is  highest  during  the  night.  The  constitutional 
symptoms  are  more  violent  just  before  the  eruption,  but  immediately 
subside,  and  soon  disappear,  when  the  breaking  out  is  established. 
The  eruption  is  at  first  in  the  shape  of  small  red  points,  which  are 
hard  to  the  touch,  and  shaped  like  a cone,  and  are  proportionate  in 
number  to  the  subsequent  pustules.  In  Plate  II  the  artist  has 
well  exhibited  the  developed  disease,  as  well  as  the  progress  of  the 
eruption  from  day  to  day. 

Treatment.  — Like  the  two  preceding  diseases,  the  ordinary,  un- 
complicated form  of  this  requires  only  the  most  simple  treatment. 
Not  much  is  wanted,  except  confinement  in  bed,  cooling  drinks,  cool 
and  even  temperature,  frequent  change  of  linen,  and  sponging  the 
body  with  cool  water.  But  when  what  is  called  the  fever  of  inva- 
sion is  past,  and  the  eruption  is  fully  developed,  and  has  brought 
along  with  it  the  secondary  fever,  then  some  recipe,  as  (131),  (356), 
(125)  will  be  in  place,  and  some  gentle  laxative  to  keep  the  bowels 
open  (8),  — also  gentle  injections  (249),  and  opiates  to  relieve 
sleeplessness  and  nervous  symptoms ; (356)  (357)  may  be  used  if 
very  sleepless. 

Should  the  system,  at  this  period,  appear  to  be  sinking,  a more 
generous  diet,  and  a little  wine  may  be  allowed.  If  the  brain 
suffers,  apply  cold  ice-cloths  to  head,  or  an  ice-bag  behind  the  ears, 
and  put  the  feet  in  a mustard  bath  (242).  If  the  breaking  out 
appears  with  difficulty,  put  the  patient  into  a warm  bath,  and  give 
extract  of  jaborandi  (358).  Gargles  will  frequently  be  needed  for 
the  inflammation,  and  dryness  of  the  mouth  and  throat  (243). 
Cold  sponging  may  be  considered  as  highly  beneficial,  in  both  the 
primary  and  secondary  fever.  The  belladonna  likewise  is  a useful 
remedy,  used  in  the  same  way  as  in  scarlet  fever.  The  plaster  (288), 
applied  to  the  face,  will,  it  is  said,  arrest  the  formation  of  matter, 
and  prevent  the  unsightly  scars  which  so  often  cover  the  face  of 
persons  who  have  suffered  from  small-pox.  Paint  the  face  once  or 
twice  a day  with  glycerine,  which  will  effectually  prevent  pitting. 
The  use  of  flexible  collodion  is  better. 

To  avoid  Pitting,  and  the  occurrence  of  unsightly  scars  of  the 
face,  several  methods  of  dressing  have  been  used.  The  simplest 
consists  in  covering  in  the  vesicle  with  iodoform-collodion,  say, 
twenty  grains  of  the  former  to  one  ounce  of  the  latter.  Having 
pricked  the  vesicle  with  an  absolutely  clean  needle,  one,  for  instance, 
that  has  been  boiled  in  soda-water  for  five  minutes,  a layer  of  this 
collodion  should  be  applied  and  allowed  to  dry  on  at  once.  Should 
pus  form  under  this  coating  it  must  be  released  by  washing  off  the 
collodion  with  alcohol.  The  wound  is  then  to  be  thoroughly  disin- 


162 


SKIN  DISEASES. 


fected  with  carbolic  acid  water  (one  teaspoonful  to  pint  of  water) 
and  the  collodion  again  applied. 

This  process  will  avoid  most  of  the  pitting. 

Varioloid. — Mild  Small-Pox. 

Varioloid,  or  modified  small-pox,  begins  with  symptoms  similar 
to  those  of  small-pox,  but  much  milder  in  degree.  These  symptoms 
are  feverishness,  nausea,  vomiting,  pains  in  the  loins  and  head,  and 
a quickened  pulse.  The  eruption  comes  out  on  the  third  or  fourth 
day,  and  looks  like  that  of  small-pox.  It  reaches  its  height  the 
fourth  or  fifth  day,  and  then  declines  without  any  secondary  fever. 
The  pustules  dry  up  and  form  brown  scabs  which  fall  off  in  a few 
days,  and  leave  slight  pits,  and  a few  red  or  purple  spots. 

Chicken  Pox. — Varicella. 

Chicken-pox  is  a contagious  disease,  associated  with  mild  fever  and 
a blister-like  eruption  called  blebs  over  the  body. 

Symptoms. — The  disease  appears  usually  from  two  to  three  weeks 
after  exposure  of  the  child  to  some  one  else  similarly  affected.  At 
first  a mild  fever  and  feeling  of  tiredness  causes  the  patient  to  stay 
indoors,  though  intense  pain  in  the  head,  back  and  legs  with  high 
temperature,  vomiting  and  even  delirium  are  not  uncommon. 

The  eruption  usually  appears  in  one  to  three  days  and  are  small, 
watery  blisters  averaging  one-eighth  of  an  inch  in  size.  They  are 
more  numerous  over  the  chest  and  trunk,  occasionally  over  the  face 
and  forehead  and  even  in  the  roof  of  the  mouth.  They  do  not  have 
the  so-called  shotty  feeling  when  pressed  to  the  bursting  point  under 
the  finger  as  in  smallpox,  neither  is  the  red  blush  around  them  so 
marked. 

Unless  scratched  by  the  finger  nails  or  a very  severe  case,  very  few 
scars  will  remain. 

Treatment. — The  treatment  is  practically  a mild  diet  for  a few 
days,  keeping  the  patient  indoors  to  avoid  exposure  to  cold  or  wet 
and  some  simple  medicine  as  sweet  spirits  of  nitre  in  dose  of  half  a 
teaspoonful  in  water  every  three  hours  to  allay  fever  and  keep  the  kid- 
neys working  properly. 


Cow-Pox.  — Vaccina. 

This  disease  exists  to  some  extent  among  lower  animals,  and  is 
identical  with  small-pox  in  man.  The  immortal  Jenner  taught  the 
world  that  the  pus  taken  from  the  cov/  having  this  disease,  and  in- 
troduced under  the  skin  of  man,  would  produce  an  eruption  similar 
to  that  of  small-pox,  and  that  this  would  protect  the  system  from 
the  latter  disease.  This  was  an  immensely  important  discovery,  and 
will  render  the  name  of  Jenner  famous  through  all  time. 

Before  this  discovery  smallpox  killed  in  England  as  many  persons 


ERYSIPELAS 


SKIN  DISEASES. 


163 


as  all  other  diseases  combined.  To-day,  if  a person  has  even  been 
vaccinated  once  in  their  life  the  chance  of  death  is  only  thirty  out  of 
one  hundred,  while  if  never  vaccinated  about  sixty  per  cent.  die.  If 
vaccinated  and  the  ‘‘scar”  is  plain,  not  over  eight  per  cent.  die. 

It  is  usually  a wise  precaution  to  be  re  vaccina  ted  once  in  eight 
years,  especially  if  an  epidemic  of  smallpox  appears. 

The  Second  Group  of  diseases,  characterized  by  inflammation  of 
the  true  skin,  without  constitutional  symptoms  of  a specific  kind,  are 
Erysipelas,  Nettle-Rash,  False-Measles,  and  Inflammatory  Blush. 

Erysipelas.  — St.  Anthony's  Fire. 

Eeysipelas  is  a diffused  inflammation  of  the  skin,  affecting  only 
a part  of  the  surface  of  the  body,  and  is  accompanied  by  a fever, 
which  is  generally  thought  to  be  infectious  and  contagious.  The 
local  inflammation  is  disposed  to  spread;  it  extends  deep,  and  is 
attended  by  swelling,  a tingling,  burning,  and  pungent  heat,  and  by 
a redness,  which  disappears  when  the  skin  is  pressed  by  the  finger, 
and  returns  on  remitting  the  pressure. 

Symptoms.  — The  constitutional  symptoms  are  chilliness  and 
shaking,  succeeded  by  heat ; lowness  of  spirits,  lassitude,  pains  in 
the  back  and  limbs,  pains  in  the  head,  quick  and  hard  pulse,  thirst, 
loss  of  appetite,  white  and  coated  tongue,  bitterness  of  mouth, 
nausea,  vomiting,  pain  in  stomach,  and  costiveness. 

These  symptoms  go  before  the  local  inflammation  several  days; 
they  increase  with  the  redness  of  the  skin,  and  disappear  upon  its 
decline.  The  nervous  system  is  sometimes  severely  affected,  and 
indicated  by  low,  muttering  delirium.  At  the  close  of  the  inflam- 
mation there  is  generally  a relaxation  of  the  bowels,  and  the  scarf- 
skin  peels  off.  Sometimes  matter  forms  under  the  skin,  and  occa- 
sionally mortification  occurs.  The  face  is  the  most  frequent  seat  of 
the  disease.  It  commonly  begins  on  one  side  of  the  nose,  and  soon 
spreads  over  one  side  of  the  face,  closing  up  the  eye,  and  changing 
the  features  in  a shocking  manner.  See  Plate  III,  Fig.  1. 

Somewhere  about  the  third,  fourth,  or  fifth  day,  very  minute  blis- 
ters appear  on  the  inflamed  parts,  filled  with  water,  which  increases 
until  the  blisters  break  and  let  it  out.  The  disease  comes  to  a head 
on  the  eighth  or  ninth  day,  when  the  blistered  parts  dry,  and  the 
skin  begins  to  peel  off. 

Treatment.  — In  the  treatment  two  things  are  to  be  done,  — to 
subdue  the  fever,  and  the  local  inflammation.  The  fever  is  assuaged 
by  rest,  mild  diet,  gentle  laxatives  (26),  (21),  (125) ; and  by  the 
use  of  tincture  of  veratrum.  For  the  local  inflammation,  various 
things  have  been  advised,  but  nitrate  of  silver,  on  the  whole,  has  the 
preference.  First  wash  the  inflamed  part  with  soap  and  water  to 
remove  any  oily  substance,  and  wipe  the  skin  dry.  A solution  of 
nitrate  of  silver  will  in  many  cases,  according  to  Dr.  Higginbottom, 


164 


SKIN  DISEASES. 


do  even  better.  Use  a solution  of  80  grains  of  silver  nitrate  to  half  an 
ounce  of  water  that  has  been  boiled  and  then  cooled.  Apply  with  a 
camel’s  hair  brush  over  the  entire  inflamed  area  and  for  a small 
space  beyond. 

Apply  two  or  three  times  to  secure  a firm  coating  but  use  carefully 
to  avoid  sloughing.  A perhaps  better  remedy  than  any  is  to  apply 
after  washing  with  water  and  castile  soap,  a thick  coating  of  icthyol 
with  vaseline  equal  parts.  Cover  this  application  with  oil  paper  or 
absorbent  cotton  as  it  will  stain  the  clothes. 

In  mild  cases,  flour  may  be  dusted  on  the  inflamed  part  from  the 
dredging-box.  Warm  fomentations  are  also  useful,  and  cloths  wet 
with  water,  and  laid  on.  A solution  of  percliloride  of  iron,  applied 
to  the  inflamed  skin,  is  much  used  now,  or  water  as  hot  as  can  be 
borne. 

In  erysipelas  the  powers  of  the  system  are  generally  reduced,  and 
tonics,  such  as  quinine,  wine,  etc.,  are  generally  required.  Dr. 
Eobert  Williams,  — high  authority  in  these  matters,  — says  he  puts 
his  patients  upon  milk  diet,  gentl}"  opens  the  bowels,  and  gives  them, 
daily,  from  four  to  six  ounces  of  port  wine,  together  with  sago,  and 
that  he  seldom  has  to  change  this  course,  whatever  the  symptoms. 

For  the  inflamed  skin,  a tea  made  of  buckwheat  meal  is  a good 
wash.  Alcohol  and  water,  or  new  rum,  may  be  used  for  the  same 
purpose. 


NettIe=Rash. — Urticaria. 

Nettle-rash  begins  with  fever,  which  lasts  two  or  three  days, 
when  wheals  of  various  shapes,  round,  oval,  and  oblong,  appear  in 
the  midst  of  red,  slightly  elevated  patches,  attended  by  great  itching 
and  tingling,  as  if  the  common  nettle  had  been  applied  to  the  skin. 
The  wheals  go  off  during  the  day,  and  come  again  at  night.  The 
eruption  is  often  a symptom  of  other  diseases,  or  of  mental  anxiety. 
Sometimes  it  is  the  effect  of  articles  of  diet.  Children  have  it  occa- 
sionally while  cutting  teeth.  A lighter  form  of  the  disease  exists,  in 
which  the  wheals  appear  and  disappear  at  short  intervals,  according 
to  the  heat  of  the  weather,  the  exercise,  diet,  etc. 

Treatment. — The  treatment  varies  according  to  the  cause  of  the 
disease.  If  this  be  anything  offending  the  stomach,  especially  if  it  be 
putrid  fish,  an  emetic  (2),  (4)  will  be  required,  followed  by  brisk 
physic  (359).  After  which  take  a few  doses  of  quinine  (75).  For 
external  application,  the  lotion  (216)  or  common  vinegar  and  water 
(215)  will  be  useful.  Dr.  Wilson  recommends  corrosive  sublimate, 
etc.  (217),  as  the  best  lotion  to  apply  outwardly.  Soda  bath  better. 

The  diet  should  be  simple  and  cooling,  all  stimulating  food  and 
condiments  being  avoided.  Fruit,  candies,  and  berries  often  the 
cause. 


SKIN  diseases. 


165 


Rose-Rash. — Roseola.  — False  Measles. 

Symptoms. — The  summer  rose-rash  appears  first  on  the  arms,  face, 
and  neck,  thence  it  spreads  over  the  whole  body,  producing  tingling 
and  itching.  It  is  usually  preceded  by  the  symptoms  of  fever-chills, 
succeeded  by  flushes  of  heat,  languor,  pains  in  the  head,  back,  and 
hmbs,  restlessness,  quick  pulse,  and  thirst.  The  rash  appears  in 
small  irregular  patches,  paler  than  those  of  measles,  and  of  a more 
roseate  hue.  There  is  some  hoarseness  from  inflammation  of  the 
throat.  The  rash  never  continues  more  than  five  days,  unless  it  be 
merely  partial,  in  which  case  it  sometimes  comes  and  goes  at  inter- 
vals for  weeks.  If  it  “ strike  in,”  it  generally  produces  disturbance 
of  the  stomach,  headache,  and  faintness,  which  are  relieved  by  its  re- 
appearance. 

The  autumnal  rose  rash  is  in  more  distinct  patches  than  the  former, 
of  a circular  figure,  slightly  elevated,  and  of  a dark  damask-rose  hue. 
Seldom  any  fever,  or  itching  and  tingling. 

Treatment. — For  the  first-described  form  of  the  disease,  light  diet, 
acid  drinks,  and  gentle  laxatives;  for  the  second,  recipe  69  or  51,  ac- 
cording to  convenience. 

Inflammatory  Blush.  — Erythema. 

What  is  called  marginated  inflammatory  blush,  is  a mottled,  red, 
smooth  fullness  of  the  skin,  occurring  on  the  extremities  and  loins,  in 
irregular  patches,  bounded  on  one  side  by  a hard,  elevated,  red  border. 
This  species  of  disease  attacks  old  people,  and  indicates  some  inte’..- 
nal  disorder,  which  is  dangerous. 

Another  form  of  the  complaint  appears  on  the  arms,  neck,  and 
breast,  in  extensive,  bright-red,  irregular  patches,  slightly  elevated. 
The  redness,  at  its  height,  is  very  vivid,  and  continues  about  a fort- 
night, when  it  assumes  a purplish  hue  in  the  centre. 

Treatment. — .Light  diet,  gentle  purgatives  (21),  soda  bath  to  al- 
lay the  tingling  and  secure  sleep,  and  the  mineral  acids  (63),  with 
bitter  tonics,  comprise  all  that  is  required,  except  sponging  with 
water,  and  friction. 


Watery  Pimples. 

We  now  come  to  a class  of  diseases  character.zed  by  watery  pim- 
ples. Wilson  says  they  are  distinguished  by  “ effusive  inflammation  of 
the  derma,”  which  means  that  there  is  inflammation  of  the  true  skin, 
which  causes  water  to  be  poured  out  on  top  of  the  derma,  and  under- 
neath the  scarf-skin,  causing  the  latter  to  be  lifted  up  in  the  form  of 
small  or  large  blisters,  or  vesicles.  At  first  the  fluid  in  these  pimples 
is  transparent,  but  in  a short  time  becomes  milky.  Sometimes  this 
fluid  absorbs ; at  other  times,  it  dries  up,  and  with  the  cuticle  scales 
off  as  scurf. 


166 


SKIN  biSEASEg. 


Eczema  and  Salt  Rheum. 

Eczema  is  an  inflammatory,  acute  or  chronic,  non-contagious  skin 
disease  characterized  at  first  by  redness,  little  pimples,  vesicles  or 
pustules  and  is  attended  by  more  or  less  burning  itching.  This  pro- 
cess terminates  either  in  the  formation  of  crusts  as  the  lesult  of  dried 
sticky  serum,  or  else  in  the  formation  of  fine  scales. 

No  skin  disease  has  such  a variety  of  aspects  nor  such  grades  of 
inflammation.  There  is  generally  more  or  less  oozing  of  the  blood- 
serum,  which  dries  and  thickens,  forming  crusts.  There  is  usually 
more  or  less  thickening  of  the  skin,  making  it  like  leather;  there  is 
generally  some  considerable  scaling. 

Eczema  may  subside  in  a few  weeks  never  to  return,  or,  what  is 
more  probable,  may  lapse  into  a chronic  state  and  continue  for  months 
and  years,  with  bothersome  symptoms,  which  are  extremely  annoying. 

5alt  Rheum  is  a chronic  eczema  of  this  last  variety. 

Treatment. — In  the  acute  stage  of  eczema,  soothing  lotions,  pow- 
ders, or  ointments  should  be  used,  such  as  372,  373,  374.  Some  are 
better  treated  with  powders,  some  by  lotions ; the  itching  and  heat 
are  best,  relieved  by  373. 

In  the  more  chronic  variety  some  stimulating  ointments  are  needed, 
like  375.  Carbolic  acid,  10  or  15  grains  to  the  ounce  of  oleate  of 
zinc  ointment,  is  an  admirable  remedy  for  the  itching  and  burning. 
Salicylic  acid,  10  grains  to  the  ounce  of  benzoated  zinc  ointment 
is  likewise  very  serviceable,  while  tarry  preparations  generally  are 
the  most  satisfactory  in  this  chronic  stage. 

No  skin  disease,  however,  is  often  so  stubborn  to  treatment  as  the 
different  forms  of  eczema.  The  cure  often  will  be  slow  and  medi- 
cines frequently  changed.  The  local  varieties  of  eczema  require  spe- 
cial treatment. 

Eczema  of  Head  in  Children. — After  oiling  freely  the  crusts  over 
night  and  washing  off  with  suds  in  the  morning,  apply  Salicylic  acid, 
1 part,  tincture  benzoin,  2 parts,  vaseline,  50  parts.  The  very  chronic, 
thick,  and  indurated  skins  require  360,  and  in  many  cases  219,  espe- 
cially the  chronic  hand-cracks.  The  diet  must  be  free  from  irritating 
articles  of  food,  the  bowels  regulated  and  the  hygiene  of  the  skin  at- 
tended to,  while  tonics  and  general  systemic  measures  are  often  called 
for. 

Tetter  — Shingles. — Herpes. 

After  a slight  feverish  attack,  lasting  two  or  three  days,  clusters 
of  small,  transparent  pimples,  filled  sometimes  with  a colorless,  some- 
times with  a brownish  lymph,  appear  on  the  cheeks  or  forehead,  or 
on  the  extremities,  — and  at  times  on  the  body.  The  pimples  are  a 
little  larger  than  in  eczema, — about  the  size  of  a pea.  After  a few 


SKIN  DISEASES. 


167 


days  the  vesicles  break,  pour  out  their  fluid,  and  form  brown  or  yel- 
low crusts,  which  fall  off  about  the  tenth  day,  leaving  the  surface  red 
and  irritable.  The  eruption  is  attended  with  heat,  itching,  tingling- 
ever  and  restlessness,  especially  at  night.  Ringworm  is  a curious 
torm  of  herpes,  in  which  the  inflamed  patches  assume  the  form  of  a 
ring.  Shingles  usually  attack  the  aged  about  the  ribs  of  one  side, 
and  are  evidences  of  impaired  health  and  nutrition.  They  are  very 
prostrating  and  require  tonics  from  the  start. 

Treatment.—  Light  diet,  gentle  laxatives.  If  the  patient  be  ad- 
vanced in  life,  and  feeble,  a tonic  (75)  will  be  desirable.  For  exter- 
nal  application,  belladonna  (173),  or  an  ointment  of  sulphuret  of  lime, 
(174),  or  elder-flower  ointment,  etc.  (175).  Equal  parts  of  chloral 
aud  camphor  applied  several  times  a day,  especially  later  in  the  disease 
(361),  give  most  relief. 


Itch. — Scabies. 

To  this  disease  all  classes  are  liable,  though  it  is  much  less  com- 
mon than  in  foriner  years.  It  is  found  frequently  among  the  poor, 
whose  condition  in  life  does  not  give  them  the  means  to  guard  at  all 

S dSnefs 

Symptoms.-  An  eruption  of  distinct,  cone-like,  watery  pimples 
which  are  transparent  at  the  summits,  and  are  accompanied  by  an  ex- 
cessive Itching,  which  is  made  worse  by  high-seasoned  food,  by  drink- 
er ST  ^^^heat  of  the  bed.  When  these  pimples  are 

scratched  and  torn,  a sticky,  watery  fluid  is  poured  out,  which  forms 
small  scabs ; and,  in  time,  if  the  disease  is  not  cured,  these  scabs  be- 
ing torn  off,  extensive  sores  are  made. 

anS!  wonder  of  many  readers  to  state  that 

animals  of  so  small  a size  as  scarcely  to  be  seen  with  the  naked  eye 
exist  in  the  skin  of  man.  Yet  such  is  the  fact ; and  it  is  the  present 
of  these  minute  creatures,  or  the  effect  of  their  presence,  which  con- 

leuD-ih  seventy-seventh  part  of  an  inch  in 

heautff;.!  J inspected  under  the  microscope,  is  really  a 

beautiful,  I may  say  an  elegant,  animal.  Here  are  a front,  a side,  and 
a back  view  of  him,  well  done  by  the  artist. 


168 


SKIN  DISEASES. 


Fig.  73.  Fig.  74.  Fig.  76. 


His  Method  of  Attack. — When  placed  upon  the  skin,  the  little 
fellow,  like  the  squirrel  and  other  ground-animals,  sets  himself  to 
make  a hole  through  the  scarf-skin  with  his  head  and  fore  feet.  Into 
this  he  pushes  his  whole  body.  He  then  begins  to  burrow  himself  in 
the  derma  or  true  skin  — making  a channel  many  times  his  own 
length,  at  the  end  excavating  a chamber  where  he  sleeps,  and  whence 
he  goes  out  to  do  his  day’s  work  at  mining,  or  boring  for  food.  When 
tired  of  this  sleeping  apartment,  he  digs  onward  and  scoops  out  an- 
other. 

This  travelling,  and  boring,  and  turning  about  in  an  organ  as  sen- 
sitive as  the  true  skin,  must,  of  course,  occasion  a tickling  and  itch- 
ing; and  from  this  circumstance  the  disease  took  its  name  of  itch. 
But  this  itching  is  not  painful.  James  the  First  is  said  to  have  re- 
marked that  the  itch  was  fitted  only  for  kings  — so  exquisite  is  the 
enjoyment  of  scratching.  Probably  it  is  a royal  luxury.  Be  that  as 
it  may,  most  persons  would  consent  to  have  it  all  done  by  royal  fin- 
gers. They  have  been  used  for  meaner  purposes. 

Treatment. — Whatever  will  kill  the  little  animal  described  above, 
will  cure  the  itch.  Various  agents  have  been  employed  for  this  pur- 
pose, but  none  have  been  found  equal  to  sulphur.  The  compound 
sulphur  ointment  is  a sovereign  remedy  for  the  disease.  Four  ounces 
of  this  should  be  well  rubbed  into  the  skin,  before  the  fire,  morning 
and  evening,  for  three  or  four  days.  This  will  put  an  end  to  the 
whole  colony  of  these  sovereign  squatters  upon  forbidden  soil. 

Two  ounces  of  sulphuret  of  potash,  and  the  same  amount  of  soft- 
soap,  dissolved  in  a pint  of  water,  and  applied  well  to  the  skin,  is 
used  in  many  cases  with  good  effect. 

Caustic  potash,  one  part  to  twelve  parts  of  water,  applied  in  a sim- 
ilar way,  is  said  to  be  a pretty  sure  remedy. 

A solution  of  the  chloride  of  lime,  used  as  a wash,  will  often  effect 
a cure. 

The  ointment  of  the  American  hellebore  sometimes  does  well. 

Before  applying  any  of  these  preparations,  let  the  skin  he  washed 
with  warm  water  and  soap,  and  well  dried.  Be  sure  the  parasite  is 


SjKlN  DISEASES.  109 

bsfore  063-8111^  treatment.  Best  to  continue  few  days  longer 
than  what  is  apparently  needed. 

Rupia. 

This  is  from  a Greek  word  which  means  dirt,  from  the  dirt-colored 
crusts  which  are  formed  after  the  breaking  of  the  large  watery  pim- 
ples. The  vesicles  are  like  those  of  eczema  and  herpes,  except  that 
they  are  larger.  This  is  distinguished  from  all  other  skin  diseases  by 
the  formation  of  unhealthy,  foul,  and  burrowing  sores,  which  pour 
out  a reddish  matter  in  such  quantities  that  it  collects  and  dries  upon 
the  sore,  and  forms  a crust  of  great  thickness,  — sometimes  of  the 
size  of  an  oyster-shell.  Rupia  has  its  origin  in  a weakly  and  debili- 
tated constitution,  and  cannot  be  cured  without  renovating  the  whole 
system.  It  is  a manifestation  either  of  syphilis  or  lupus. 

Treatment, — arm  baths  once  or  twice  a week,  with  generous 

and  nutritious  diet.  Tonic  medicines  (63)  (51)  (67)  (61)  (65)  will 
be  required.  For  external  treatment,  dust  the  surface  of  the  ulcers 
with  cream  of  tartar,  or  apply  nitrate  of  silver  (214)  (219)  (220) 
white  vitrol,  etc.  See  syphilis.  ^ 

Pemphigus.  — Pompholix. 

The  first  of  these  terms  is  from  the  Greek,  and  means  a bubble  ; 
the  second,  pompholix,  is  from  the  same  language,  and  means  a water- 
bubble.  This  is  still  more  applicable  to  the  disease  in  hand,  which 
consists,  in  fact,  in  the  raising  up  of  the  scarf-skin  in  the  shape  of 
bubbles,  containing  a watery  fluid.  These  bubbles  are  just  like  com- 
mon blisters.  They  vary  from  the  size  of  a split  pea  to  that  of  a 
hen’s  egg.  They  rise  up  very  rapidly,  and  break  in  two  or  three 
days,  leaving  a raw  surface  which  soon  becomes  covered  by  a thin 
crust. 

Treatment.—  Similar  to  that  for  Rupia,  with  the  addition  of  iodide 
of  potassium  (140),  and  applying  the  stick  nitrate  of  silver  to  the 
whole  surface  of  the  ulcer,  and  a short  distance  beyond  it  on  all  sides, 
or  the  ointment  (176).  See  treatment  for  syphilis. 

Mattery  Pimples. 

Another  natural  group  of  skin  diseases  are  distinguished  by  an 
eruption  of  pimples,  filled,  not  with  water,  like  those  just  described, 
but  with  matter.  The  pimples  of  this  class  are  not  transparent,  or 
whitish,  but  opaque  and  yellow  from  the  first.  The  matter  is  poured 
out  upon  the  true  skin,  and  raises  up  the  scarf-skin,  in  the  same  way 
as  the  watery  pimples.  As  in  the  preceding  diseases,  too,  the  drying 
up  of  the  matter  forms  crusts.  But  these  pimples  are  never  so  small 
as  those  of  eczema,  nor  so  large  as  those  of  pemphigus. 


170 


SKIN  DISEASES. 


Crusted  Tetter.  — Impetigo. 

This  eruption  consists  at  first  of  slightly-elevated  pustules  or  pim- 
ples, closely  congregated,  with  an  inflamed  border.  These  break,  and 
the  surface  becomes  red,  excoriated,  shining  and  full  of  pores,  through 
which  a thin,  unhealthy  fluid  is  poured  out,  which  gradually  hardens 
into  dark,  yellowish-green  scabs.  These  scabs  sometimes  look  like  a 
dab  of  honey  dried  upon  the  skin.  This  has  given  impetigo  the  name 
of  “honey  disease,”  or  honey  scab.  This  honeyed  look  is  well  repre- 
sented in  the  crusts  which  form  on  the  lips  and  ears  of  children. 
Sometimes  these  scabs  cover  nearly  the  whole  face,  and  are  called  the 
milk  crust.  This  is  putting  the  agreeable  words  milh  and  honey  to 
rather  questionable  uses ! When  this  crusted  tetter  invades  the  head 
or  scalp,  it  causes  the  hair  to  fall,  and  becomes  what  is  called  a scall. 
Impetigo  may  be  simple,  or  contagious,  or  syphilitic. 

Treatment. — The  vapor  bath,  and  water  dressing.  The  following 
ointments  are  useful : oxide  of  zinc,  white  precipitate,  or  diluted  ni- 
trate of  mercury  (178).  Hydrocyanic  acid  (221),  applied  externally, 
has  a fine  effect.  The  crusts  sliould  first  be  removed  by  a weak  lye 
made  from  hard- wood  ashes,  or  potash ; then,  after  applying  one  of 
the  ointments  above,  or  the  lotion,  cover  the  part  with  oil-skin.  If 
the  crusts  are  on  the  head,  the  hair  should  be  cropped  off  before  the 
remedies  are  applied.  When  of  syphilitic  origin,  treat  as  for  that 
disease. 


Papulous  Scall.  — Ecthyma. 

The  mattery  pimple  called  ecthyma  is  developed  on  a highly  in- 
flamed skin.  The  bladders  are  about  the  size  of  a split  pea,  and  are 
surrounded  by  a broad  ring  of  redness.  They  are  generally  separate, 
not  clustered  like  impetigo.  They  are  scattered  over  various  parts  of 
the  body,  and  are  followed  either  by  a hard  black  crust,  or  by  a sore. 
The  disease  is  either  acute  or  chronic.  The  latter  attacks  weakly 
children,  and  persons  reduced  by  sickness  or  low  living. 

Treatment. — For  the  acute  form,  give  a generous  diet,  with  oint- 
ment (176),  and  the  cold  sponge-bath  on  the  sound  parts.  Use 
(176)  (175)  (214)  (211)  for  external  application.  Hygienic  treat- 
ment, tonics,  and  stimulants  are  called  for ; iron,  quinine,  arsenic,  and 
nux  vomica. 


Scaly  Eruptions. 

The  scaiy  eruption  is  called  a dry  tetter.  It  is  an  inflammation  of 
the  true  skin,  and  is  distinguished  from  the  rashes  and  pimples  by 
the  alteration  of  the  scarf-sHn.  The  diseases  forming  this  group  are 
three  in  number, — lepra,  psoriasis,  and  pityriasis. 


SKIN  DISEASES. 


171 


Leprosy.  — Lepra. 

In  this  disease,  the  eruption  makes  its  appearance  as  a small,  sal- 
mon-red  spot,  raised  a little  above  the  surrounding  skin,  and  consti- 
tuting, in  fact,  a flat  pimple,  almost  as  large  at  the  top  as  at  the  bot- 
tom. On  top  of  this  pimple  the  scarf-skin  becomes  rough,  and  after 
a little  while  a thin  scale  is  produced.  New  layers  are  added  to  its 
under  surface,  and  it  accordingly  grows  thicker.  It  has  a bright, 
silvery  lustre.  These  scaly  spots  multiply,  and  become  the  form  of 
leprosy  called  lepra  guttata,  from  the  Latin  gutta,  a drop,  the  scales 
looking  like  drops  of  water  on  the  skin. 

But  the  eruption  more  frequently  spreads  out  into  circular  patches, 
of  the  size  of  a flfty-cent  piece.  These  generally  appear  below  the 
elbows  and  knees,  and  on  the  breast  and  shoulders,  and  back  of  the 
hands.  Sometimes  the  entire  hand  is  covered  with  scales  of  a pecu- 
liar silvery  whiteness.  These  patches  heal  from  the  centre. 

Psoriasis. 

This  differs  from  lepra  in  the  erupldon  being  more  irregular.  The 
spots  sometimes  come  out  in  thick  clusters,  and  blend  in  various 
ways.  Instead  of  appearing  in  distinct  circular  forms,  as  in  leprosy, 
the  patches  are  irregular,  and  of  every  size.  Instead  of  one  well- 
formed  and  thick  scale,  there  are  many  small  and  thin  ones.  And 
instead  of  a depressed  centre  with  rising  edges,  the  surface  is  level. 
While  leprosy  is  a circular  dry  tetter,  this  is  an  irregular  dry  tetter. 

Treatment. — Pyrogallic  acid  in  ointment,  10  to  40  gr.  to  oz.  Ap- 
ply daily ; it  discolors  the  skin  for  a while.  Chrysoplianic  acid  in 
same  strength  is  the  best  remedy  known.  It  also  discolors  the  skin 
and  inflames  the  neighboring  skin  for  a while.  Recently  the  thyroid 
gland  of  the  sheep  has  been  used  in  five-grain  tablets  three  times 
daily  as  an  internal  medicine  with  much  success. 

Pityriasis. 

This  is  much  like  the  two  preceding,  except  that  it  gives  rise  to 
a copious  production  of  very  small  bran-like  scales.  Indeed,  its  name 
is  from  the  Greek,  and  means  chaff  or  bran.  It  is  a branny  tetter. 
It  may  occur  on  any  part  of  the  body. 

Treatment. — When  the  skin  is  highly  inflamed  and  stiff  with  heat, 
pain,  and  itching,  the  diet  should  be  light,  and  the  drinks  of  a cooling 
and  unexciting  kind.  The  warm  bath  and  gentle  friction  of  the  skin 
are  useful.  Laxatives  or  tonics  may  be  employed,  according  to  the 
indications,  — frequently  laxatives  first,  and  tonics  afterwards.  The 
specific  remedies  for  curing  the  disease  are  unknown ; iodide  of  potas- 
sium (140),  arseniate  of  iron  (68),  Fowler’s  solution,  in  two-drop 
doses,  three  times  a day  •,  or  Donovan’s  solution,  in  five-drop  doses. 


172 


SKIN  DISEASES. 


three  times  a day.  For  external  application,  use  a naphthaline  oint- 
ment (177),  zinc  ointment,  white  precipitate  ointment,  diluted  nitrate 
of  mercury  ointment,  or  solution  of  corrosive  sublimate  (212). 

Dry  Pimples. 

These  are  distinguished  by  the  high  degree  of  irritation  of  the 
skin  which  they  create.  They  are  exceedingly  troublesome,  not  only 
from  the  distress  and  itching  they  occasion,  but  because  they  are 
likely,  in  consequence  of  this,  to  be  torn  into  painful  and  obstinate 
sores. 

When  appearing  in  children,  they  are  called  red  gum,  and  tooth- 
rash.  In  grown  persons,  one  form  is  named  lichen,  and  another,  dis- 
tinguished by  excessive  itching,  prurigo. 

In  this  form  of  pimples,  the  fluid  is  not  poured  out  upon  the  sur- 
face of  the  true  skin,  — as  in  several  of  the  preceding  diseases,  — but 
is  collected  within  the  tissue  of  this  organ,  and  the  pimples  feel  hard 
under  the  finger. 

The  tooth-rash  of  infants  is  always  accompanied  with  some  fever- 
ishness, caused  generally  by  irritation  of  the  gums  from  growing  teeth, 
occasionally  by  flannel  worn  next  the  skin. 

Lichen  has  a variety  of  forms.  In  one  case  the  pimples  are  of  a 
bright  red,  in  another,  bluish  or  livid.  In  one  case  they  appear  in 
circular  groups,  in  another  they  produce  great  disorganization  of  the 
skin,  and  occasion  terrible  suffering. 

Prurigo  is  a stiff  more  cruel  disease  than  lichen.  The  pimples  are 
not  very  manifest,  but  the  skin  is  thickened  or  swollen,  and  con- 
densed. The  suffering  from  it  is  terrible.  It  gives  one  no  sleep, 
night  or  day.  That  form  of  it  called  ant-bite  prurigo  gives  the  sen- 
sation of  millions  of  ants  eating  the  flesh,  or  as  many  red-hot  needles 
piercing  it.  This  renders  the  existence  of  many  elderly  persons  a 
terrible  burden. 

Treatment. — Careful  diet,  and  gentle  aperients  and  tonics,  accord- 
ing to  the  condition  of  the  system.  Externally,  the  cold  salt-water 
sponge-bath,  and  glycerine,  vinegar  and  water,  applied  with  a soft 
sponge.  Tar  and  sulphur  are  among  the  more  successful  remedies  in 
fighting  this  rebellious  disease  (362).  Iron,  quinine,  cod-liver  oil. 
For  relieving  the  terrible  itching  of  the  private  parts,  which  females 
sometimes  suffer,  I have  found  morphine  (223),  for  external  use, 
very  effectual. 

Lupus. 

This  makes  its  appearance  in  the  form  of  one  or  more  circular 
elevations,  of  a duff  red  or  salmon-color,  and  partially  transparent. 
When  pressed  under  the  finger,  these  elevations  are  found  to  be  soft. 


SKIN  DISEASES. 


173 


and  when  the  finger  is  removed,  they  are  flat  and  whitened.  They 
generally  appear  on  the  face,  and  particularly  the  nose. 

In  another  and  worse  form  of  the  disease,  the  tubercles  are  harder ; 
and  after  a time,  they  become  covered  with  thin  brown  scabs,  winch 
are  scratched  off,  and  followed  by  others, 
and  these  by  others,  until  ulcers  appear, 
which  are  sometimes  slow  and  sometimes 
rapid  in  their  progress.  The  whole  nose 
has  been  destroyed  by  them  in  a month. 

(See  Fig.  76.)  This  is  one  of  the  dis- 
eases which  Erasmus  Wilson  thinks,  and, 
in  my  judgment,  correctly,  to  be,  like 
scrofula,  the  result  of  tubercular  poison, 
filtered  through  the  blood  of  several 
generations.  It  is  a disease  which  is  the 
most  destructive  in  the  shortest  time  of 
all  diseases. 


Treatment. — The  internal  remedies 
are  iodide  of  arsenic  (141),  and  iodide 
of  potassium  (140)  ; the  external,  vine- 
gar of  Spanish  flies  ; and  to  promote  the 
healing  of  the  ulcers,  a weak  solution  of  nitrate  of  silver  (211)  (214) 
is  adapted. 

Hardly  any  disease  has  been  treated  by  so  many  different  remedies. 
At  present  the  prospect  of  a cure  is  good,  as  certain  anti-tubercular 
lymph  injections  have  been  found  effective ; but  no  time  should  be 
lost  in  immediately  consulting  a surgeon,  as  its  growth  can  be  ar- 
rested, and  the  disease  may  be  exterminated  by  early  treatment. 


Warts  and  Corns. — Verruca  — Tylosis  — Clovus. 

In  the  derma  or  true-skin  there  are  a great  many  small  arteries, 
veins,  and  nerves,  united  together,  and  formed  into  loops  (see  Fig. 
43),  resembling,  in  shape,  the  peaks  of  miniature  mountains.  These 
are  called  papillce.  These  loops,  frequently,  without  any  apparent 
cause,  take  on  a disposition  to  grow,  and  by  extending  themselves 
upward,  they  carry  the  scarf-skin  along  with  them,  which  is  thickened; 
and  together  they  form  what  is  called  warts.  Corns  are  formed  by  a 
somewhat  similar  growth  of  the  papillae,  brought  about  by  the  pres- 
sure and  friction  of  tight  boots  and  shoes. 

Treatment. — For  warts,  take  a piece  of  diachylon  plaster,  cut  a 
hole  in  the  centre  the  size  of  the  wart,  and  stick  it  on,  the  wart  pro- 
jecting through.  Then  touch  it  daily  with  aqua  fortis.  Nitrate  of 
silver  sometimes  answers  well  for  touching  it.  They  may  be  taken 
off  very  neatly,  sometimes,  by  t3dng  a string  tight  around  them. 
Corns  should  be  shaved  down  close,  after  being  soaked  in  warm 


174 


SKIN  DISEASES. 


water  and  soap,  and  then  covered  with  a piece  of  wash-leather,  or 
buckskin,  on  which  lead  plaster  is  spread,  a hole  being  cut  in  the 
leather  the  size  of  the  corn.  They  may  be  softened,  so  as  to  be  easily 
scooped  out,  by  rubbing  glycerine  on  them.  Manganic  acid  destroys 
warts  and  corns  rapidly.  Bunions,  which  affect  the  joint  of  the  great 
toe,  must  be  treated  with  fomentations,  and  sugar  of  lead  water 
(224),  when  there  is  considerable  inflammation,  with  rest  in  a hor- 
izontal position.  But  the  best  cure  for  corns  and  bunions  is  to  put 
away  tight  shoes.  Wear  a bunion-plaster  for  some  time  to  take  the 
pressure  off  of  the  corn  or  bunion. 

Mother’s  Marks. — Naevus. 

The  small  vessels  of  the  skin,  called  capillaiies,  suffer  certain  al- 
terations of  structure  which  pass  under  the  name  of  mother’s  marks. 
These  marks  are  simply  a great  dilatation  of  these  minute  blood-ves- 
sels. They  vary  in  size  from  a mere  point  to  a patch  of  several 
inches  square. 

The  smallest  of  all  is  the  spider  mark.  It  is  a small  red  point, 
from  which  several  little  straggling  vessels  spread  out  on  all  sides. 
Sometimes  this  is  of  the  size  and  appearance  of  a red  currant ; at 
other  times,  of  a strawberry  or  raspberry ; and  occasionally  it  is  even 
much  larger,  and  is  compared  to  a lobster. 

When  the  circulation  is  active  through  them,  or  the  individual  is 
excited  by  exercise,  or  by  moral  causes,  these  marks  are  of  a bright 
red  color.  Some  are  naturally  livid  and  dark-colored,  and  look  like 
blackberries,  and  black  currants.  The  blueness  of  these  is  owing  to 
the  vessels  being  still  more  stretched  and  dilated,  and  to  the  conse- 
quent slower  passage  of  the  blood  through  them,  which  gives  more 
time  for  its  change  from  the  arterial  red  to  the  venous  blue. 

Treatment. — If  the  mark  is  not  making  progress,  it  had  better  be 
let  alone,  or  only  subjected  to  gentle  pressure  by  putting  a piece  of 
soap-plaster  over  it.  When  its  course  is  threatening  mischief,  it  is 
sometimes  cured  by  pencilling  a small  portion  of  its  surface,  from 
time  to  time,  with  nitric  acid.  They  may  be  operated  on  with  safety 
by  electrolysis  and  other  methods. 

Disordered  State  of  the  Nerves  of  the  Skin. 

Itching. — Pruritus.  This  is  supposed  to  be  dependent  on  an  al- 
tered condition  of  the  nerves  of  the  skin,  and  consists  in  a painful 
sensation  of  itching.  There  is  no  perceptible  alteration  in  the  ap- 
pearance or  structure  of  the  skin.  Tliis  itching  is  thought,  generally, 
to  be  a result  of  sympathy,  through  the  nerves,  with  some  diseased 
and  excited  condition  of  a distant  part.  The  itching  is  brought  on 
by  the  most  trifling  causes,  and  for  hours  may  deprive  the  sufferer  of 
every  particle  of  repose.  It  more  frequently  affects  the  fundament, 
or  the  private  parts,  particularly  the  scrotum. 


SKIN  DISEASES. 


175 


Treatment. — As  this  disease  is  only  a symptom  of  several  others, 
the  constitutional  treatment  belongs  under  the  heads  of  these  other 
diseases.  The  local  applications  for  relieving  the  itching  are,  a solu- 
tion of  sugar  of  lead  (224),  hydrocyanic  acid  (363),  of  corrosive  sub- 
limate (212),  diluted  nitrate  of  mercury  ointment,  and  poppy  fomen- 
tations. Also  (223).  Tonics  are  often  of  first  importance.  Weak 
solutions  of  carbolic  acid  or  soda  water  at  times  suffice. 

Disorders  Affecting  the  Color  of  the  Skin. 

Colored  Patches. — Maculce.  The  depth  of  color  in  the  skin  de- 
pends on  the  amount  of  a certain  coloring  matter,  called  pigment,  in- 
corporated with  the  deeper  and  softer  portion  of  the  scarf-skin.  In 
the  scarf-skin  of  the  inhabitants  of  northern  latitudes,  there  is  but 
little  of  this  pigment ; in  that  of  the  dwellers  of  Africa,  there  is  a 
great  deal ; among  the  inhabitants  of  Southern  Europe,  the  quantity 
is  intermediate  between  the  two. 

The  depth  of  color  in  the  skin  depends  on  the  energy  of  its  action. 
In  the  tropics,  where  light  and  heat  are  in  excess,  the  skin  is  stimu- 
lated to  great  action,  just  as  vegetation  is,  and  the  color  is  increased 
and  intensified.  This  is  illustrated  6very  year  before  our  eyes.  In 
summer,  under  the  heat  of  the  sun  and  the  flood  of  light,  the  pigment- 
forming power  is  increased,  and  the  fairest  skin  is  browned ; while 
the  withdrawal  of  these  forces  leaves  the  winter’s  scarf  without  pig- 
ment, and  blanched. 

What  the  sun  and  light  do,  under  natural  circumstances,  diseased 
action  may  effect.  Hence  we  occasionally  meet  with  alterations  of 
color  in  the  skin,  from  a disordered  state  of  the  system.  We  witness 
the  formation  of  patches  of  dark  color  and  irregular  shape  on  various 
parts  of  the  body.  Sometimes  they  are  raised  above  the  level  of  the 
skin,  and  are  called  moles.  At  other  times,  they  have  no  elevation, 
and  spread  over  the  whole  body. 

Occasionally,  from  some  peculiarity  of  constitution,  the  pigment  is 
diminished,  and  white  patches  appear  all  over  the  body.  At  other 
times,  a black  person  will  become  completely  white.  Such  are  called 
albinos. 

In  many  cases  the  coloring  of  the  skin  has  varieties  of  tint,  as  when 
persons  of  light  complexion,  are,  in  the  summer  season,  covered  with 
yellow  spots,  like  stains.  These  spots  are  known  by  the  name  of 
freckles,  or,  in  learned  language,  lentigo. 

Treatment. — It  is  generally  best  not  to  meddle  with  a mole.  If  it 
be  very  unsightly,  let  it  be  removed  by  two  incisions,  taking  out  an 
elliptical  portion  of  skin,  and  closing  the  wound  with  sticking  plaster. 
In  the  case  of  bleached  places,  apply  the  shower  bath,  tonics,  and  a 
stimulating  liniment  (163)  to  the  faded  spots.  For  the  change  of 
color  called  sunburn,  a liniment  (191)  of  lime-water,  etc.,  is  the  best 
preparation.  For  freckles,  use  recipe  360,  or,  perhaps,  still  better, 
364. 


176 


<SK1N  DISEASES. 


Disorders  of  the  5weat=Qlands. 

The  perspiration  is  sometimes  greatly  increased  above  nature’s  de- 
sign. This  is,  technically,  idrosis.  In  other  instances  there  is  too 
little  sweating.  This  is  called  anidrosis.  Sometimes  the  perspiration 
is  so  altered  in  its  physical  qualities  as  to  have  some  peculiar  smell. 
This  is  osmidrosis.  In  some  rare  instances,  according  to  old  writers, 
the  sweat  was  changed  in  color.  This  was  chromidrosis.  And  now 
and  then  a case  occurs  of  bloody  perspiration,  of  which  the  most 
memorable  case  on  record  is  that  of  the  Redeemer  of  men,  who,  in 
the  garden,  sweat  great  drops  of  blood.  Several  cases  of  this  are  re- 
corded in  medical  books.  It  is  called  hcemidrosis. 

The  proper  action  of  the  skin  being  so  vitally  important  to  health, 
these  changes  often  involve  very  serious  consequences. 

Treatment. — Either  too  much  or  too  little  sweating  can  generally 
be  corrected  by  the  cold  or  warm  bath,  friction,  tonics,  and  proper 
clothing.  Small  doses  of  jaborandi,  also  ergot  and  strychnine,  are 
among  the  best  internal  medicines  (365). 

Disorders  of  the  Oil=GIands  and  Tubes. 

That  tbe  skin  may  be  limber,  healthy,  and  fit  for  use,  it  is  neces- 
sary to  have  it  oiled  every  day.  For  this  object,  the  Creator  has 
wisely  provided,  by  placing  in  the  true  skin  a large  number  of  very 
small  glands  and  tubes,*  whose  office  it  is  to  prepare  and  pour  out 
upon  the  surface  the  proper  amount  of  oil.  The  gland,  regular  little 
oil-pot,  is  in  the  true  skin  ; and  from  it  a piece  of  hose  or  tube  runs 
up  through  the  scarf-skin,  through  which  the  oily  fluid  is  poured  out. 
Some  of  these  tubes  are  spiral,  others  are  straight.  On  some  parts 
these  vessels  do  not  exist ; on  others  they  are  quite  abundant,  — as  on 
the  face,  nose,  ears,  head,  eyelids,  etc.  They  produce  the  wax  of  the 
ears ; and  on  the  head,  they  open  into  the  sheath  of  the  hair,  and  fur- 
nish it  with  a hair-oil  or  pomatum  better  than  the  chemist  can  make. 

These  little  vessels  are  always  at  work,  when  the  skin  is  healthy ; 
and  no  persons  need  be  afraid  to  wash  all  over  every  day,  lest,  as  the 
Boston  Medical  Journal  taught,  the  skin  will  be  injured  by  having 
the  oil  removed  from  it.  You  might  as  well  be  afraid  to  eat  a 
meal  of  victuals,  lest  the  saliva  should  all  be  swallowed  with  it,  and 
none  be  left  for  future  use.  There  is  oil  enough  where  that  upon 
the  skin  comes  from,  and  the  vessels  which  produce  it  are  not  injured 
by  work,  any  more  than  the  muscles  of  the  legs  are  by  walking. 

Grubs  or  Worms. — But,  unfortunately,  the  skin  is  not  well  taken 
care  of  in  all  cases,  as  in  cities  and  towns  where  sedentary  habits  pre- 
vail. Here,  the  actions  of  the  skin,  instead  of  being  regular  and  com- 
plete, are  often  sluggish  and  imperfect ; and  the  contents  of  the  oil- 
cells  and  tubes,  instead  of  flowing  easily,  become  hard  and  impacted, 
and  the  vessels  are  not  emptied.  When  this  matter  becomes  station- 


SKIN  DISEASES. 


177 


ary,  dry,  and  hard,  it  distends  the  tube,  and  fills  it  to  the  surface ; and 
then  coming  in  contact  with  the  dust 
and  smoke  of  the  atmosphere,  the  ends 
become  black,  and  look  like  the  heads 
of  worms.  These  spots  are  common 
on  the  nose  and  face  of  persons  who 
have  a sluggish  skin.  They  may  be 
squeezed  out  by  pressing  the  nails  on 
each  side  of  them.  These  are  called 
grubs  and  worms^  or,  technically,  come- 
dones. When  this  matter  produces  in- 
flammation of  the  tube,  there  is  then  a 
black  spot  in  the  middle  of  a red  pimple, 
and  the  disease  is  called  spotted  acne. 

Now  and  then  the  oily  matter  becomes  very  hard,  producing  spine- 
like growths,  and  even  horns  (Fig.  77)  ; and  again,  it  collects  and 
forms  soft  tumors,  as  wens,  etc.  These  are  technically  called  encysted 
tumors.  Sometimes  the  action  of  the  glands  is  too  great,  and  oil  is 
poured  out  so  profusely  that  the  face  shines  with  it.  At  other  times 
there  is  so  little  that  the  skin  is  dry  and  harsh.  In  the  hardened 
oily  matter,  which  constitutes  grubs,  are  found  small  animals,  which 
Dr.  Wilson  calls  the  “animal  of  the  oily  product  of  the  skin.” 

Below  are  three  views  of  him. 


Treatment. — For  roughness  and  harshness  oi  skin,  wash  with  soap 
and  water  every  night,  and  rub  well  into  the  skin  after  the  bath,  and 
in  the  morning,  the  ointment  (362),  and  take  a dose  of  sulphur,  etc. 
(23),  twice  a week.  Or,  rub  the  skin  every  morning  with  a damp 


Fig.  78.  Fig.  79.  Fig.  80. 


sponge  dipped  in  fine  oatmeal,  and  after  drying  the  surface,  the  link 
ment  (164)  may  he  applied.  The  spinous  variety,  or  porcupine  dis- 
ease, requires  washing  with  a quart  of  warm  water,  having  a large 


178 


SKIN  DISEASES. 


tcaspoonful  of  saleratus  dissolved  in  it,  and  the  use  of  the  ointment 
(181)  twice  a day.  For  grubs,  stimulate  the  skin  by  washing  it 
with  strong  soapsuds,  twice  a day,  and  rubbing  briskly  with  a coarse 
towel;  and  by  using  the  corrosive  sublimate  (225)  as  a lotion. 

A spare  diet  will  do  much  towards  improving  the  skin  in  many 
cases;  use  tonics  in  others.  Usually,  destroy  the  old  skin  first  (360) 
and  apply  after  (362)  to  heal. 

Barbers’  Itch. — Jackson’s  Itch.  — Sycosis. 

This  is  very  much  like  ac?ie,  — only  differing  from  it  in  its  loca- 
tion. It  appears  chiefly  on  the  hairy  parts  of  the  face,  — the  chin, 
the  upper  lip,  the  region  of  the  whiskers,  the  eyebrows,  and  the  nape 
of  the  neck.  It  consists  in  little  conical  elevations,  which  maturate 
at  the  top,  and  have  the  shaft  of  a hair  passing  through  them.  These 
pimples  are  of  a pale  yellowish  color.  In  a few  days  they  burst,  and 
the  matter  running  out,  forms  into  hard,  brownish  crusts.  These 
crusts  fall  off  in  one  or  two  weeks,  leaving  purplish,  sluggish  pimples 
behind,  which  disappear  very  slowly. 

The  eruption  is  preceded  by  a painful  sensation  of  heat,  and  tight- 
ness of  the  skin. 

Barber’s  Itch. 

Barber ’s  itch  is  a variety  of  ringworm  though  confined  to  the 
region  of  the  face  covered  by  the  beard.  Whether  of  the  body,  the  scalp 
or  the  face,  this  disease  is  highly  contagious,  being  communicated  to 
other  persons  through  the  medium  of  soiled  hands,  unclean  towels, 
razors,  strops,  brushes,  etc.  A vegetable  fungus  called  the  tricho- 
phyton is  the  source  of  the  infection. 

Symptoms. — Small  reddish  pea-sized  rings  with  minute  vesicles  or 
watery  blisters  appear,  they  spread,  branny  scales  form,  the  blisters 
maturate,  itching  becomes  noticeable  and  other  areas  rapidly  take  on 
the  same  appearances.  The  surrounding  skin  becomes  congested  and 
reddened,  a gluey,  yellowish,  sticky  fluid  exudes  from  the  scabs  and 
thicker  crusts  pile  up  on  each  other.  The  hairs  of  the  affected  part 
break  off  very  easily  or  fall  out. 

As  this  disease  is  so  contagious,  great  care  should  be  taken  to  use 
individual  towels,  that  the  face  should  be  shaved  if  possible  by  the 
person  afflicted  and  of  course  kissing  the  children  or  holding  their 
cheeks  up  against  the  infected  cheeks  must  be  i prohibited. 

Treatment. — Although  a tedious  course  may  be  expected  to  pre- 
sent itself,  yet  the  greater  the  care  used  the  sooner  a cure  will  be 
eft'ected.  First  with  almond  or  olive  oil  soften  the  parts  for  two 
days,  then  shave  every  day  or  at  least  every  other  day,  and  after 
washing  off  with  warm  water  apply  freely  an  ointment  of  twenty 
grains  of  sulphur,  fifteen  grains  of  boracic  acid  mixed  in  half  an  ounce 
of  benzoinated  lard.  This  salve  should  be  well  rubbed  in  and  a 
supply  kept  on  the  face,  enough  to  make  it  look  greasy  day  and 
night  until  cured, 


SKIN  DISEASES. 


179 


Disorders  of  the  Hair  and  Hair-Tubes. 

The  hair  is  an  appendage  of  the  scarf-skin,  and  is  intended  to  be 
both  useful  and  ornamental. 

It  is  subject  to  several  disorders.  It  may  grow  too  long,  or  too 
thick,  or  it  may  appear  in  an  improper  place.  This  last  happens  in 
the  case  of  those  little  spots  and  patches  which  disfigure  the  face, 
and  are  called  moles.  The  hair  may  be  defective  in  its  growth,  or 
may  fall  off  prematurely  from  various  causes,  or  in  the  natural  course 
of  things  from  old  age.  This  last  is  called  calvities.  It  may  change 
its  color,  too,  under  a great  variety  of  circumstances,  and  at  nearly 
every  age.  It  is  not  very  uncommon  to  find  a single  lock  varying  in 
color  from  that  which  surrounds  it.  Old  age,  the  winter  of  life,  nat- 
urally brings  the  frosted  locks;  but  they  frequently  appear  also  upon 
the  heads  of  younger  persons.  Strong  mental  emotions,  such  as  fear, 
grief,  or  sorrow,  may  bring  a bleaching  of  the  hair  in  a brief  period, 
or  even  suddenly. 

Porrigo. — There  is  a troublesome  disease  of  the  hair  and  hair-tubes 
called  porrigo.  It  begins  with  the  formation  of  a thin  layer  of  scurf 
either  around  single  hairs,  or  in  patches  which  enclose  several.  These 
patches  frequently  have  a circular  form,  which  give  to  the  affection 
the  character  of  a ringworm.  The  hair-tubes  are  generally  a little 
elevated,  in  the  shape  Df  papillae,  which  gives  to  the  diseased  scalp 
the  appearance  of  “goose-flesh.”  These  hairs,  losing  their  proper 
nourishment  and  healthiness,  break  off  at  unequal  distances  from  the 
skin,  leaving  their  rough  ends  twisted  and  bent,  and  matted  into 
thick  grayish  and  yellow  crusts.  Upon  the  surface  of  these  crusts 
may  generally  be  seen  the  ends  of  a few  hairs,  looking  like  the  fibres 
of  hemp  or  tow.  The  scratching  causes  inflammation  of  the  skin  after 
a time,  and  matter  is  poured  out,  which  still  further  mats  the  hair, 
and  thickens  the  crusts.  There  are  several  varieties  of  this  disease, 
differing  slightly  from  each  other ; but  this  general  description  will 
answer  all  practical  purposes  for  this  work. 

The  reader  will  often  notice  a disease  of  the  hair-glands,  character- 
ized by  a yellowish  and  dirty-looking  powder,  covering  the  scalp  and 
hairs.  This  matter  is  collected  at  the  mouths  of  the  follicles,  and 
considerable  of  it  is  strung  upon  the  hairs  like  beads.  Pull  out  a 
hair,  and  the  root  will  be  found  thin,  dry,  and  starved  in  its  appear 
ance.  In  this  disease,  it  is  difficult  to  keep  the  hair  cleansed,  or  to 
prevent  its  falling  off. 

Favus. — Still  another  disease,  called  favus.,  is  known  by  the  collec- 
tion of  a yellow  substance,  at  first,  around  the  cylinder  of  the  hair. 
This  substance,  after  a time,  spreads  out  upon  the  scarf  skin,  and 
dries  into  yellow  crusts,  in  the  form  of  a cup,  around  the  base  of  each 
hair.  A number  of  these  cups,  collected  together,  look  like  the  cells 
of  a honey-comb.  This  disease  is  contagious,  and  is  communicable 
by  contact  to  any  part  of  the  skin. 


180 


SKIN  DISEASES. 


Treatment. — For  removing  the  hair  from  particular  parts  of  the 
scalp,  it  is  common  to  resort  to  depilatories.  Of  these,  the  recipes 
260,  261,  262,  are  frequently  used,  and  are  as  good  as  those  adver- 
tised; indeed,  they  are  the  same.  Forceps  are  the  best  means. 

To  prevent  loss  of  hair,  and  to  restore  it  when  lost,  the  circulation 
should  be  stimulated  in  the  small  vessels  of  the  scalp.  With  this 
view,  washing  the  head  every  morning  with  cold  water,  drying  it  by 
friction  with  a rough  towel,  and  brushing  it  to  redness  with  a stiff 
hair-brush,  are  excellent.  To  these  should  be  added  some  stimulating 
ointment  (183),  or  liniment  (257),  (258),  (259).  These  last  are  about 
the  best  known  preparations  for  causing  the  growth  of  the  hair. 

Ringworm  of  the  scalp  requires  attention  to  the  diet,  and  such 
'remedies  as  will  improve  the  general  health,  with  stimulating  appli- 
cations externally  (257),  (258),  (259).  366  is  the  newest  and  best 

mode. 

To  color  the  hair,  several  preparations  are  used.  Of  these,  263  is 
about  the  best.  It  produces  a beautiful  black.  A preparation  of  sul- 
phur and  sugar  of  lead  (264)  is  the  famous  compound  recommended 
by  General  Twiggs,  and  extensively  used.  Preparations  of  nitrate  of 
silver  (265),  (266),  (311)  are  much  in  use  in  some  quarters.  They 
perhaps  give  a finer  black  to  the  hair,  but  they  render  it  dry  and  crisp, 
and  they  will  stain  the  skin,  if  care  is  not  used  in  applying  them. 

Use  care  in  the  use  of  these  remedies. 

In  Favus,  the  two  great  objects  to  be  gained  are,  to  remove  all  lo- 
cal causes  of  irritation,  and  to  excite  the  diseased  hair-glands  to 
healthy  action.  The  first  object  is  affected  by  cutting  off  the  hair 
with  the  scissors,  and  removing  the  crusts  by  washing  the  scalp  with 
castile  soap  and  water.  It  may  be  well  first  to  wet  the  crusts  through 
with  corrosive  sublimate  (212),  in  weak  solution  The  washing  with 
soap  and  water  should  be  repeated  every  day,  and  be  followed  by 
rubbing  into  the  scalp  a stimulating  ointment  (183;.  A very  weak 
solution  of  the  nitrate  of  mercury  (226),  applied  every  other  day, 
with  a camel’s  hair  brush,  sometimes  produces  excellent  effects. 


Lice. 

Pediculosis  or  Lice  is  a contagious,  animal,  parasitic  affection, 
characterized  by  the  presence  of  pediculi  in  the  skin  and  scratch- 
marks  of  the  sufferer  ensuing  from  the  annoying  itching.  There  are 
a number  of  varieties  classified  according  to  the  peculiar  parasite  and 
its  location.  They  all  cause  great  discomfort  and  itching. 

The  Pediculosis  Capitis,  or  head-louse,  is  found  in  the  scalp,  and 
is  a long,  oval  body  with  six  legs  furnished  with  nails ; it  has  an  oval 
head  with  two  prominent  eyes  and  two  horns.  The  ova  or  nits  are 


SKllt  DISEASED. 


181 


small  whitish  bodies  closely  glued,  to  the  hair 
and  look  like  small  pieces  of  dandruff.  One  or 
two  are  deposited  on  a hair. 

They  occur  for  the  most  part  in  poorly  nour- 
ished children  brought  up  under  bad  hygienic 
surroundings,  and  thence  communicated  to 
others.  They  cause  extreme  itching  and  scratch- 
ing, so  that  often  the  irritation  is  unbearable  and 
the  sticky  serum  of  the  blood  mats  together  the 
hair,  forming  crusts.  Sleep  is  often  interfered 
with  and  ill  health  results.  (See  Fig.  81.) 

Pediculosis  Corporis,  or  body-louse,  is  gen- 
erally the  property  of  the  clothing ; it  is  some- 
what larger  than  the  head-louse  and  deposits  its 
eggs  in  the  seams  of  the  clothing,  remaining  on  the  body  only  long 
enough  to  gain  sustenance.  The  young  are  hatched  in  five  or  six 
days.  The  louse  reproduces  again  in 
eighteen  days.  As  the  parasite  crawls 
about  it  produces  extreme  itching  and 
the  scratching  follows,  resulting  in  long 
lines  of  excoriation.  The  chief  locations 
for  this  parasite  are  the  back,  chest,  abdo- 
men and  thighs.  The  middle-aged  and 
elderly  are  more  apt  to  be  attacked  than 
the  young.  Here  uncleanliness  again  is  a 
prime  factor  in  their  occurrence.  (Fig.82.) 

Pediculosis  Pubis,  or  crab-louse,  is  a 
smaller,  shorter,  stouter  parasite  than  the 
two  preceding,  and  attacks  the  pubes  par- 
ticularly, but  is  also  found  in  the  axillae 
and  over  the  eyelashes  and  beard  of  the 
male.  They  may  be  seen  clinging  closely  to 
the  skin  with  remarkable  tenacity.  They 
occur  on  adults  and  produce  the  same  lesions  as  the  other  varieties. 
They  are  generally  the  result  of  promiscuous  sexual  intercourse. 
(Fig.  83.) 

Treatment. — The  main  object  in  the  treat- 
ment of  these  filthy  diseases  is  the  destruction 
of  the  parasite.  The  lesions  they  produce 
disappear  with  the  disappearance  of  the  ani- 
mal. It  need  hardly  be  said  that  strict  clean- 
liness of  person  is  a sine  qua  non.  The  rem- 
edies usuall}'^  employed  in  their  extermination 
are  the  mercurials,  sulphur,  caibolic  acid,  to- 
bacco, etc. 

In  case  of  the  head-louse  the  most  effica- 
cious  method  of  treatment  consists  in  saturating  the  head  over  night 


Fig.  82. 

BODY-LOUSE. 


Fig.  81. 


HEAD-LOUSE. 


182 


SKIN  DISEASES. 


with  petroleum  and  washing  off  with  soap  in  the  morning.  In  young 
children  the  hair  may  be  cut  to  get  rid  the  more  easily  of  the  nits, 
but  this  is  not  necessary.  The  applications  of  petroleum  may  have 
to  be  repeated  several  times  and  the  hair  frequently  washed  with  soft 
soap,  soda  washes,  vinegar,  etc.,  to  get  rid  of  the  nits.  If  the  louse 
be  of  the  body  variety  the  treatment  must  be  directed  to  the  clothing, 
which  is  to  be  changed  often  and  either  boiled  or  baked.  This  pro- 
cess is  to  be  repeated  until  no  more  parasites  are  found.  The  itching 
of  the  body  is  best  allayed  by  carbolic  acid  lotions  (one  teaspoonful 
to  pint  of  water). 

The  crab-louse  is  best  treated  by  the  well-known  mercurial  oint- 
ment, or  blue  ointment,  and  is  to  be  washed  off  with  soap  and  water 
each  morning.  It  must  be  persisted  in  till  no  more  crabs  are  found 
and  no  further  itching  is  noticed. 

Bed=Bugs. 

The  best  preventives  against  these  annoying  bugs  is  corrosive  sub- 
limate and  pyrethrum  powder.  Purchase  a small  bottle  of  the  corro- 
sive sublimate  tablets,  usually  sold  at  the  druggists  for  surgical  pur- 
poses, and  dissolve  one  in  a quart  of  water.  This  solution  is  to  be 
freely  used  about  the  cracks  of  the  bed,  after  it  has  been  taken  apart, 
and  also  about  any  wooden  furniture  of  the  room  as  well  as  the  wood- 
work of  the  room.  The  powder  is  then  to  be  used  freely.  This  pro- 
cess is  to  be  repeated  several  times. 

The  bites  themselves  are  best  relieved  by  carbolic  lotions,  vinegar 
and  water,  ammonia  and  water,  etc. 

Freckles. 

This  is  a disease  of  the  pigment  layer  of  the  skin  and  consists  in 
a deposit  of  the  coloring  matter  of  the  skin  in  irregular  shapes, 
of  the  size  of  a pin-head  or  pea,  and  are  yellowish,  brown  or  even 
blackish,  occurring  for  the  most  part  on  the  face  and  back  of  the 
hands.  They  may  be  few  and  scattered  or  exceedingly  abundant 
and  cover  a large  area.  All  ages  are  subject  to  them  except  in  very 
young  children.  The  light-complexioned  are  more  subject  to  them, 
while  the  red-haired  seldom  escape  them.  Sunlight  develops  them  so 
that  many  have  them  conspicuously  only  in  summer.  The  possession 
of  freckles  is  a matter  greatly  of  idiosyncrasy,  as  many  people  never 
have  them,  no  matter  how  much  they  may  be  subjected  to  the  sun. 

Treatment. — One’s  aim  in  treatment  should  be  toward  destrojdng 
the  pigment  layer  by  some  corrosive  agent,  like  corrosive  sublimate, 
which  perhaps  is  the  best  remedy. 

Two  grains  to  the  ounce  in  water  will  in  most  cases  prove  sufl&- 
ciently  strong.  The  susceptibility  of  the  skin  to  this  remedy  and  the 
extent  of  the  area  involved  have  much  to  do  with  the  strength  of  the 


SKIN  DISEASES. 


183 


remedy  employed.  This  remedy  is  poisonous  and  is  to  be  used  with 
care.  Do  not  get  it  near  the  lips,  but  to  effect  a cure  it  must  be  per- 
sisted in  for  quite  a while. 

Washing  the  face  in  buttermilk  several  times  a day  is  excellent. 

Corns. 

Of  all  the  minor  ailments  of  the  human  body,  few  are  more  dis- 
tressing than  the  inflamed  corn.  They  consist  of  a thickening  of  the 
outside  or  horny  layer  of  the  skin.  As  a secondary  change,  conse- 
quent on  long  irritation,  the  nerve  and  blood  supply  increase  and  an 
extreme  tenderness  is  produced,  amounting  often  to  incapacity  to 
walk  or  work.  They  are  caused  mechanically  by  the  undue  pressure 
of  the  boot  against  the  joint  or  by  one  toe  pressing  against  another. 
Too  short  a boot,  which  causes  pushing  out  of  the  big  toe  joint,  too 
narrow  a boot,  causing  crowding  of  the  large  joints,  are  the  more  fre- 
quent causes  of  the  corn. 

Bunion. 

The  bunion  is  produced  by  wearing  too  short  a boot,  as  a rule,  and 
consists  in  the  gradual  displacement  of  the  big-toe  joint,  so  that  fi- 
nally there  is  an  actual  deformity.  The  corn  usually  is  added  to  this 
deformity. 

Treatment. — The  outer  layers  jf  the  corn  should  be  softened  and 
scraped  off  by  a sharp,  thin  knife.  The  softening  process  may  be  ef- 
fected by  soaking  in  a soda  solution,  or  better  still,  by  the  following 
mixture : — 

Salicylic  acid one-half  ounce 

Extract  cannabis  indica ten  grains 

Collodion one  scruple 

This  is  to  be  applied  each  night.  Care  is  to  be  exercised  in  not 
paring  the  corn  too  closely  lest  bleeding  occur  and  poisoning  ensue 
from  the  unclean  knife  that  may  be  used.  Pressure  of  the  boot  must 
be  avoided  by  the  substitution  of  another  form  of  boot  and  also  per- 
haps by  wearing  a plaster  with  a hole  in  the  center,  thus  distributing 
the  pressure  over  a greater  area.  When  trimmed  the  corn  is  to  be 
likewise  covered  by  a corn-plaster  bound  on  the  foot  by  strips  of 
adhesive  plaster.  Painting  with  iodine  often  takes  out  the  sore- 
ness and  hardens  the  skin  so  that  ^t  may  be  more  readily  cut.  In- 
flamed corns  should  be  poulticed  and  treated  like  any  pus  wound. 
Spirits  of  turpentine  will  often  take  the  soreness  out  of  a corn.  Ab- 
sorbent cotton,  or  better,  wool,  worn  between  the  toes,  will  prevent 
or  cure  a corn  between  the  toes. 

Dandruff. 

This  is  a disease  of  the  sebaceous  glands  of  the  scalp,  characterized 


184 


SKIN  DISEASES. 


by  a large  secretion  of  the  sebaceous  matter  and  forming  crusts  or 
scales.  The  secretion  may  be  so  thick  and  oily  as  to  mat  together 
the  hair,  or  so  dry  as  to  fall  off  the  head  in  a shower  when  the  head 
is  combed.  ' It  is  the  most  frequent  cause  of  baldness.  The  crown 
of  the  head  is  the  most  frequent  location  of  this  disease. 


Treatment.  — Inasmuch  as  those  subject  to  this  disease  are  often 
below  par  in  health,  such  constitutional  remedies  as  cod-liver  oil  and 
iron  are  valuable  adjuncts  in  bringing  about  a cure.  Should  the 
amount  of  scales  be  considerable,  especially  if  there  are  crusts,  as  in 
the  case  of  little  children,  the  best  procedure  consists  in  oiling  the 
scalp  over  night  with  some  bland  oil,  wearing  a flannel  cap,  and  wash- 
ing off  the  oil  in  the  morning  with  soft-soap  and  water.  The  follow- 
ing blood  tonic  is  an  admirable  one  for  adults  : — 


Tincture  of  iron one  ounce 

Dilute  phosphoric  acid one  ounce 

Syrup  of  lemon two  ounces 


Take  one-half  teaspoonful  in  a wineglass  of  water  three  times  daily. 
Use  a glass  tube  to  avoid  staining  the  teeth.  The  scalp  needs  a 
shampoo  once  or  twice  a week ; the  following  will  be  found  to  be  a 
suitable  one:  — 

Green  soap.  eight  ounces 

Alcohol four  ounces 

Put  a little  here  and  there  over  the  scalp  and  then  rub  up  with 
warm  water.  The  scalp  may  then  be  stimulated  night  and  morning 
with  a little  of  the  following  lotion  :[ — 


Tincture  of  cantharides three  drachms 

Tincture  of  capsicum three  drachms 

Castor  oil two  drachms 

Alcohol two  ounces 

Spirits  rosemary two  ounces 


Another  good  remedy  for  daily  use  : — 


Hydrate  of  chloral two  drachms 

Water four  ounces 

The  yolk  of  two  eggs  well  rubbed  into  the  scalp  and  afterwards 
washed  off  with  hot  water  is  also  a good  cleansing  agent  and  sham- 
poo. s, 

For  very  stubborn  cases  the  following  lotion  applied  night  and 
morning  will  be  found  efficacious : — 


Corrosive  sublimate 12  grains 

Glycerine 4 drachms 

Alcohol 5 ounces 

Spirits  rosemary 4 drachms 


‘ Whatever  method  is  pursued,  the  application  must  be  persevered 


SKIN  DISEASES. 


185 


in  and  applied  from  twice  daily  to  once  every  few  days  according  to 
progress  made  and  severity  of  case. 

Baldness. 

This  disease  is  generally  the  outcome  either  of  some  constitutional 
weakness  and  requires  general  tonic  treatment  like  iron  and  cod-oil, 
or  is  the  result  of  some  local  lesion  of  the  scalp  proper.  When  due 
to  syphilis,  the  hair  falls  out  suddenly  and  quite  extensively ; the 
eyebrows  also  suffer  the  same  way.  Its  treatment  is  to  be  conducted 
on  the  same  plans  as  directed  under  treatment  of  the  syphilitic  dis- 
ease. Eczema,  scrofulous  blood,  etc.,  may  also  be  the  exciting  cause 
of  baldness.  Baldness  may  ensue  in  areas  only,  and  oftentimes  is  as 
complete  as  though  no  hair  had  ever  grown  there.  This  form  is  apt  to 
be  very  stubborn  and  requires  very  irritating  treatment,  like  blisters 
or  the  rubbing  in  of  strong  carbolic  acid  once  a day  for  a number  of 
days  before  ceasing  treatment. 

The  baldness  of  old  age  is  of  course  irremediable,  but  may  be  ar- 
rested by  attention  to  the  general  health  and  the  employment  of  rem- 
edies mentioned  under  the  consideration  of  dandruff. 

As  has  been  mentioned,  dandruff  is  the  most  fertile  source  of  bald- 
ness. When  once  the  scalp  is  clean  and  the  dandruff  is  cured  the 
following  lotion  will  be  found  to  be  of  great  value  in  those  cases  of 
baldness  characterized  by  the  hair  falling  out  in  small  patches : — 

Carbolic  acid one  drachm 

Alcohol one  and  a half  ounces 

Castor  oil two  drachms 

Oil  bitter  almonds ten  drops 


The  following  lotion  also  contains  desirable  ingredients  : — 

Tincture  cantharides  . . . one  and  a half  ounces 

Tincture  capsicum  ....  one  and  a half  ounces 

Castor  oil two  drachms 

Cologne one  ounce 


WORD 
( BLINDNESS 


JfervQS  and . Arteries  of.Jhe  Sram..  CGRR':^ 


DISEASES  of  the  BRAIN  and  NERVES 


DISEASES  OF  THE  BRAIN  AND  NERVES. 

(Also  see  Anatomy  of  Brain  and  Nerves.) 


The  brain  and  spinal  column  are  the  great  centres  of  the  nervous 
system. 

The  brain  produces  sensation^  thought,  and  voluntary  motion.  When 
this  organ  is  diseased,  therefore,  we  may  expect  one  of  these  functions 
to  be  either  disturbed  or  destroyed. 

Of  Sensation  there  are  various  disturbances,  perversions,  and  sus- 
pensions, caused  by  disease  of  the  brain  and  nerves ; such  as  nausea, 
giddiness,  specks  floating  before  the  eyes,  ringing  in  the  ears,  decep- 
tive tastes  and  smells,  intolerable  itching,  neuralgic  pains,  boisterously 
high  spirits,  depression  without  apparent  cause,  anxiety,  and  dread. 

Thought,  in  like  manner,  is  disturbed  and  perverted  in  many  ways. 
There  is  high  delirium,  dullness  and  confusion,  loss  of  memory,  weak- 
ened judgment,  and  every  degree  of  stupor",  down  to  entire  loss  of 
consciousness. 

Voluntary  Motion  is  perverted  and  destroyed  in  muscular  twitch- 
ings,  trembling  of  the  limbs,  spasmodic  stiffness,  involuntary  jerk- 
ings,  convulsions,  muscular  debility,  and  palsy. 

The  brain  is  composed  of  three  parts, — the  cerebrum,  the  cerebel- 
lum, and  the  medulla  oblongata.  These  are  all  contained  within  the 
skull  bones,  and  are  immediately  covered  by  three  membranes,  called 
the  dura  mater,  the  arachnoid,  and  the  pia  mater.  The  dura  mater  is 
a strong,  fibrous  membrane  lying  next  to  the  skull-bones.  The  arach- 
noid is  a serous  membrane,  lying  next  below,  and  the  pia  mater,  which 
means  pious  mother,  is  a vascular  membrane,  lying  next  to  the  brain, 
dipping  into  it  in  places,  and  containing  the  vessels  which  bring  to  it 
all  its  nutrient  materials.  Hence  its  name. 

These  membranes  are  all  liable  to  be  inflamed,  — and  so  is  the 
brain. 

Inflammation  of  the  Dura  Mater. 

The  inflammation  of  this  membrane  does  not  often  occur  sponta- 
neously ; but  it  happens  frequently  from  external  injuries,  as  blows 
upon  the  head. 

After  a blow  upon  the  head  which  stuns  him,  a man  may  recover 
himself,  and  for  some  days  remain  in  perfect  health.  Then  he  has 


X88 


frontal 


Roral 


ZVeOMA 


BOn  E 


J^UPERIOI 


i-LARV 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


189 


pain  in  the  head,  is  restless,  cannot  sleep,  has  a flushed  face,  red  eyes, 
hot  skin,  hard  pulse,  rigor,  nausea,  vomiting,  — ending  with  convul- 
sions and  delirium. 

This  disease  is  often  caused  by  what  is  called  otitis,  or  inflamma- 
tion of  the  internal  ear.  In  such  cases,  inflammation  will  arise  within 
the  tympanum,  causing  intense  earache  ; matter  comes  at  length  from 
the  external  ear,  but  the  pain  does  not  stop ; the  patient  shivers,  be- 
comes drowsy,  perhaps  delirious,  and  finally  sinks  into  stupor.  The 
dura  mater  is  inflamed. 

Treatment.  — When  the  disease  arises  from  inflammation  in  the 
ear,  leeches  are  to  be  applied  behind  the  ear,  and  blisters  and  other 
irritants  afterwards.  Other  modes  of  treatment  will  be  mentioned 
after  the  next  two  forms  of  disease. 

Inflammation  of  the  Arachnoid  and  Pia  Mater. 

Arachnitis. 

These  two  membranes  are  generally  inflamed  together.  They 
are  so  intimately  connected  that  each  involves  the  other  in  its  own 
troubles. 

Generally  this  is  divided  into  three  stages : — 

The  Irritative,  characterized  by  wakefulness,  irritable  temper,  re- 
pugnance to  strong  light,  and  contraction  of  the  pupils. 

The  Inflammatory  Stage,  known  by  transient  pains  in  the  heack 
alternating  with  similar  ones  in  the  bowels,  increased  restlessness  and 
irritability,  a quick  and  tense  pulse,  an  expression  of  discontent  on 
the  face,  the  eye-brows  knit  and  frowning,  the  eye-lids  half  closed, 
retching  and  vomiting,  deep  sighing,  and  torpid  ^wels. 

The  Depressing  Stage,  in  which  the  delirium  is  more  continuous^ 
the  countenance  has  a look  of  surprise  and  stupor,  the  pupils  are  con- 
tracted or  dilated,  the  white  of  the  eyes  injected  and  red,  the  pupils 
rolled  up  during  sleep,  constant  sleepiness,  inattention  to  surrounding 
objects,  torpidity  of  mind,  gradually  increasing  until  complete  coma 
closes  all  the  senses. 

The  disease  does  not  always  exhibit  all  these  symptoms,  or  come  on 
in  the  regular  way  described.  Sometimes  the  first'  thing  noticed  is  a 
long-continued'  paroxysm  of  general  con'vulsions.  Again  these  con- 
vulsions will  come  on  after  violent  pains  in  the  head,  and  are  attended 
with  screaming. 

Inflammation  of  the  Brain.  Brain  Fever. 

Encephalitis.  — Phrenitis. 

Acute  and  general  inflammation  of  the  brain  and  its  membranes 
has  two  stages. 

The  Stage  of  Excitement,  in  which  there  is  intense  and  deep-seated 
pain  in  the  head,  extending  over  a large  part  of  it,  a feeling  of  tight- 


190 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


ness  across  the  forehead,  throbbing  of  the  temporal  arteries,  a flushed 
face,  injected  eyes,  looking  -wild  and  brilliant,  contraction  of  the  pupils, 
great  shrinking  from  light  and  violent  sound,  delirium,  want  of  sleep, 
general  convulsions,  a parched  and  dry  skin,  a quick  and  hard  pulse, 
a white  tongue,  thirst,  nausea  and  vomiting,  and  constipation  of  the 
bowels. 

The  Stage  of  Collapse,  in  which  there  are  indistinct  mutterings, 
dull  and  perverted  hearing  and  vision,  double  vision,  the  pupil  from 
being  contracted  expands  largely  and  becomes  motionless,  twitchings 
of  the  muscles,  tremors  and  palsy  of  some  of  the  limbs,  a ghastly  and 
cadaverous  countenance,  cold  sweats,  profound  coma,  and  death. 

The  disease  will  not  show  all  these  symptoms  in  any  one  case.  It 
runs  a rapid  course,  causing  death,  sometimes,  in  twelve  or  twenty- 
four  hours ; or  it  may  run  two  or  three  weeks. 

Treatment.  — This  should  be  energetic,  and  administered  early. 
The  measures  usually  employed  are  hot  foot-baths,  and  the  application 
of  cold  to  the  head,  with  occasional  mustard  poultice  to  legs. 

General  Blood-letting. — This  is  much  approved  by  many;  for 
rnyself,  I do  not  like  it.  Wet  cups  and  leeching  are  about  the  extent 
to  which  I would  ever  carry  the  abstraction  of  blood  in  these  diseases. 
These  may  sometimes  be  applied  with  advantage  to  the  neck,  and  be- 
hind the  ears. 

Cold  Applications.  — These,  applied  to  the  head,  are  of  great  im- 
portance. First,  shave  the  head,  and  put  on  cloths  wetted  in  water 
as  cold  as  it  can  be  made,  changing  them  often ; or,  put  powdered 
ice  in  a flexible  bladder,  and  lay  it  upon  the  head,  — taking  care  not 
to  make  it  too  heavy.  Heat  in  a few  cases  is  better  borne. 

Cathartics.  — These,  while  the  inflammation  is  in  the  active  stage, 
should  be  thorough  and  energetic.  To  effect  it,  many  use  calomel 
and  other  forms  of  mercury.  They  are  not  needed.  Croton  oil  is  one 
of  the  best  articles  (31),  or  colocynth,  gamboge,  etc.  (32),  without 
the  oil,  or  the  compound  powder  of  jalap. 

In  the  stage  of  collapse,  if  there  is  pallor  of  the  eountenance,  a 
feeble  and  flying  pulse,  great  debility  and  tremors,  coldness  of  the 
extremities,  etc.,  give  wine  and  other  stimulants. 

See  that  the  bladder  is  emptied  every  day. 

The  feet,  in  the  early  stage  of  the  complaint,  should  be  bathed  in 
warm  water,  or  mustard  and  water  (242).  Mustard  draughts  must 
also  be  put  upon  the  feet. 

The  tincture  of  veratrum,  given  in  full  doses,  to  bring  down  the 
pulse,  and  produce  sweating,  must  not  be  omitted.  Give  (351). 

Softening  of  the  Brain.  — Ramollissement, 

Inflammation  of  the  brain,  when  it  has  run  its  course,  sometimes 
leaves  this  organ,  or  portions  of  it,  in  a softened  condition.  The 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


191 


same  miscliief  may  happen  to  the  brain  from  the  blood-vessels  which 
run  to  it  being  diseased,  so  as  not  to  be  able  to  carry  blood  for  its 
proper  nourishment. 

Symptoms. — The  most  remarkable  symptom  of  this  disease  is  the 
rigid  contraction  of  the  muscles  which  draw  up  the  limbs ; the  hand 
may  be  clenched  and  pressed  against  the  shoulder,  or  the  heel  carried 
up  to  the  hip. 

The  early  symptoms  are  tingling,  numbness  in  the  ends  of  the  fin- 
gers, perverted  vision  and  sometimes  blindness.  The  person  usually 
tidy  in  habits  and  dress  now  becomes  careless  and  slovenly.  He 
occasionally  complains  of  sleeplessness  and  the  temper  becomes  irri- 
table and  friends  notice  that  he  takes  offense  when  usually  he  would 
not  notice.  His  forgetfulness  is  very  noticeable  at  times  to  the 
extent  of  forgetting  his  name  and  that  of  his  family,  later  on  the 
symptoms  are  similar  to  those  which  will  be  described  under  the 
heading  “Dementia.” 

Suppuration  and  Abscess  of  the  Brain. 

When  a diseased  brain  is  examined  after  death,  sometimes  matter 
is  found  mixed  in  with  the  softened  portion.  This  shows  that  suppu- 
ration took  place.  At  other  times,  the  matter  is  found  in  a cavity, 
which  shows  that  an  abscess  had  formed  during  life. 

The  symptoms  of  these  mischiefs  are  convulsions  in  the  earlier 
stages,  and  palsy  in  the  latter.  Surgical  methods  now  often  save 
life,  and  cause  a cure  in  these  cases. 

Induration  of  the  Brain. 

Instead  of  softening  the  brain,  inflammation  sometimes  does  the 
very  opposite,  — it  hardens  it,  — producing  a change  something  like 
that  which  happens  to  white  of  egg  when  dipped  in  hot  water. 

Convulsions  appear  as  the  result  of  this  change,  as  in  suppuration 
and  abscess ; palsy  much  more  seldom. 

Tumors  of  the  Brain. 

Tumors  infect  the  brain  occasionally,  — growing  around  it,  on  all 
sides,  pressing  themselves  into  its  substance,  and  causing  many  dis- 
turbances. Cancers  and  hydatids  are  found  there.  The  signs  which 
these  irritating  bodies  produce  are  like  those  of  other  diseases  of  the 
brain,  and  therefore  cannot  be  distinguished  during  life.  Syphilis  is 
often  the  cause  of  them,  and,  when  due  to  this,  may  be  cured. 

Delirium  Tremens. — Drunkard’s  Delirium. 

Mania  a Potu. 

This  is  often  mistaken  for  brain-fever ; but  it  is  quite  a different 


192 


DISEASES  OE  THE  BRAIN  AND  NERVES. 


disease.  It  is  not  the  result  of  inflammation  of  the  brain,  but  of  irri- 
tation. It  is  important  to  distinguish  it  from  inflammation,  because 
the  remedies  which  are  employed  for  that  would  be  injurious  if  used 
for  this. 

The  Symptoms  are  incessant  talking,  fidgeting  with  the  hands, 
trembling  of  the  limbs,  a rapid  pulse,  profuse  sweating,  utter  sleep- 
lessness, and  a mingling  of  the  real  with  the  imaginary  in  the  busy 
talk.  The  patient  is  apt  to  think  some  one  is  about  to  do  him  a 
great  injury,  yet  is  unwilling  to  be  alone.  His  face  is  pale  and  sal- 
low (sometimes  red  and  flushed),  his  eye  is  rolling,  quick  and  ex- 
pressive, his  speech  stuttering  and  inarticulate, — bodily  and  mentally, 
he  is  busy  day  and  night,  and  can  with  difficulty  be  confined  to  his 
bed  or  room.  As  the  disease  advances,  and  he  has  been  long  without 
sleep,  he  imagines  vermin  to  be  crawling  upon  his  scalp  and  body ; 
troops  of  rats  run  across  his  bed,  or  look  at  him  out  of  the  wall ; 
giant  boxers  confront  him,  and  he  squares  off  for  a round  at  fisti- 
cuffs ; animals,  figures  of  all  shapes,  and  horrible  monsters  frighten 
his  imagination ; devils  laugh  at  Ifim,  and  dance  before  him.  In  long 
and  sleepless  hours,  he  talks  and  chatters  with  these  spectral  phan- 
toms, — now  beckoning  them,  now  shrinking  from  them,  till  he  wears 
out  and  sinks  from  exhaustion.  This  is  a disease  of  drunkards  and 
opium  eaters.  The  attack  generally  occurs  in  consequence  of  the 
withdrawal  for  three  or  four  days  of  the  accustomed  stimulus. 

If  the  delirium  is  the  result  of  recent  heavy  drinking,  an  emetic  should 
be  administered  to  empty  the  stomach  of  what  is  remaining  there.  Sul- 
phate of  zinc,  20  grains  well  diluted  with  water,  or  ipecac,  30  grains 
may  be  given,  after  which  a good  cathartic  such  as  30  grains  of 
compound  jalap  powder  for  unloading  the  bowels  mav  be  used.  If 
the  patient  is  depressed  and  nervous,  spirits  of  aromatic  ammonia 
may  be  used.  In  more  marked  cases,  strong  black  coffee  by  the 
mouth  or  rectum;  even  strychnine  in  1-30  grain  doses  will  be  needed 
for  the  heart.  Bromide  of  soda,  30  grains  dissolved  in  one-third 
glass  of  water  may  be  given  every  two  hours  to  keep  the  patient  quiet. 
Morphia  and  the  other  preparation  of  opium,  while  very  valuable, 
should  be  used  with  great  care ; 20  drops  of  laudanum  every  two  hours 
for  two  or  three  doses  will  usually,  in  conjunction  with  the  bromide, 
quiet  the  patient,  but  the  exclusive  administration  of  opium  or  giving 
it  in  large  amounts  should  be  under  the  control  of  a physician.  Bath- 
ing the  patient  in  the  tepid  bath,  during  which  cold  applications  are 
kept  on  the  head,  may  be  used  for  hours  at  a time  if  the  patient  does 
not  rebel  at  this  treatment,  but  usually  the  quieter  he  can  be  kept 
the  sooner  he  will  recover. 

Inebriety. — Drunkenness. 

In  the  beginning  of  the  present  century  insanity  was  regarded  as  a 
visitation  of  God’s  displeasure  and  not  as  a disease  subject  to  scientific 
investigation  and  amenable  to  treatment.  Inebriety  is  regarded  now 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


193 


as  insanity  was  some  hundred  years  ago,  the  disease  being  consid- 
ered irremediable.  Alcohol  is  a poison,  and  like  other  poisons  is  cap- 
able of  destroying  life.  In  large  doses  it  becomes  a powerful  irritant 
or  a narcotic  producing  coma  and  death.  It  being  constantly  intro- 
duced into  the  system  produces  a general  disease  in  the  system.  We 
believe  inebriety  can  be  cured  like  any  other  disease,  but  is  subject  to 
relapses  like  other  diseases. 

The  “ alcohol  habit,”  under  the  title  Inebriety,  oftentimes  has  the 
S3Tnptom  or  outward  manifestation  of  diseased  conditions,  which  an- 
tedate the  alcoholic  craving,  and  are  its  predisposing  and  exciting 
causes  which  retard,  and  sometimes  even  prevent  a cure. 

In  the  popular,  and  too  often  in  the  professional  mind,  alcohol  is 
regarded  as  the  cause  and  root  of  the  whole  evil  of  inebriety.  We 
desire  to  assert  that  inebriety  is  frequently  dependent  upon  causes 
with  which  alcohol  has  nothing  to  do.  There  is  a neurotic  craving 
— it  may  be  congenital,  it  may  be  developed  as  the  result  of  disease 
or  accident.  This  craving  demands  the  various  forms  of  narcotic 
stimulants,  those  that  first  excite,  then  produce  narcosis  more  or  less 
complete.  Alcohol  fulfills  this  condition,  is  easily  accessible,  reason- 
ably inexpensive,  and  is  the  one  drug  that  meets  a morbid  craving 
that  seems  to  be  almost  universal. 

We  do  not  fail  to  recognize  the  deteriorating  effects  of  alcohol 
manifested  principally,  at  least,  more  pronouncedly  upon  the  nervous 
system  as  seen  in  the  various  forms  of  insanity.  We  also  note  the 
degenerating  effects  of  alcohol  on  lung,  liver,  kidney  or  other  organs 
and  tissues  of  the  body ; or  as  a special  poison  in  the  same  sense  that 
lead,  arsenic  and  tobacco  produce  their  effects. 

We  believe  that  the  great  majority  of  inebriates  become  so  from  he- 
redity, environment  and  disease,  that  produces  physical  degeneracy 
and  pushes  them  over  and  plunges  them  into  inebriety. 

The  patient  with  fever  craves  and  may  drink  water  freely,  exces- 
sively and  injuriously.  The  diabetic  is  an  aqua-maniac  in  a certain 
sense,  but  in  neither  case  do  we  recognize  the  aqua-mania  or  water 
craving  as  the  disease,  but  rather  as  proceeding  from  certain  abnor- 
mal conditions  which  we  readily  recognize.  So  the  liquor  thirst  is 
the  result  of  morbid  conditions  that  produce  an  abnormal  desire, 
which  alcohol  seems,  temporarily  at  least,  to  satisfy. 

The  excessive  use  of  alcohol,  while  it  is  oftentimes  the  cause  of 
various  diseases  of  the  nervous  system,  and  also  a frequent  cause  of 
insanity,  is  also  the  precursor  or  initiatory  symptom  of  certain  diseases 
of  the  nervous  system  and  also  of  insanity. 

The  paretic  will  crave  and  use  alcohol  in  the  earlier  stages  of  his 
malady.  The  victim  of  nervous  syphilis  is  addicted  to  it,  more  es- 
pecially in  the  later  stages,  when  the  nervous  system  becomes  in- 
volved. 

Any  depressing,  exhausting,  or  painful  disease  may  produce  the 
alcoholic  craving,  alcohol  being  sought  for  its  stimulating  properties. 


194 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


Alcohol,  moreover,  is  second  only  to  opium,  ether,  or  ehloroforra 
as  an  anaesthetic ; indeed,  has  been  used  as  a substitute  for  the  latter. 
Hence,  persons  find  experimentally  that  alcohol  relieves  pain,  and 
its  use  is  carried  to  a harmful  extent,  its  deleterious  effects  produced, 
and  inebriety  established. 

It  is  possible  that  a healthy  individual,  with  good  personal  and 
family  history,  may  use  alcohol  sociably  or  as  a matter  of  custom,  un- 
til the  habit  becomes  firmly  established. 

The  alcohol  breaks  down  the  constitution,  invades  and  degenerates 
the  nervous  system,  and  thus  develops  inebriety,  because  the  alcoho- 
lic degenerations,  or  even  functional  disturbances  of  the  nervous  sys- 
tem, are  the  very  conditions  under  which  inebriety  is  established. 
We  say  this  is  possible,  but  we  assert  again  that  behind  the  large 
majority  of  inebriates  will  be  found  a defective  family  or  personal 
history,  not  only  complicating  but  causing  the  inebriety ; retarding, 
oftentimes  preventing  a cure. 

It  can  be  thus  seen  that  inebriety  is  but  a symptom  — a flag  of 
distress  hung  out  by  the  nervous  system.  As  some  one  has  aptly 
said,  “ neuralgia  is  the  cry  of  a diseased  nerve,”  so  the  “ drink-craze  ” 
is  the  cry  of  the  neurasthenic  for  a stimulant,  of  the  pain-tortured 
nerve  for  an  anaesthetic,  of  the  victim  of  insomnia  for  a hypnotic. 

Not  any  patient  that  applies  for  relief  to  the  physician  needs  a 
more  careful  examination  than  does  the  inebriate.  You  may  rest  as- 
sured that  there  is  some  underlying  cause,  probably  several  that  must 
be  removed  if  we  would  restore  the  inebriate  to  his  former  habits  of 
sobriety.  If  he  is  found  suffering  from  the  later  manifestations  of 
syphilis  he  will  need  special  treatment  for  this  condition,  especially 
if  the  nervous  system  is  involved ; a painful  stricture  of  the  urethra 
may  require  division. 

Chronic  malarial  poisoning  with  its  complicating  disorder  of  stom- 
ach, liver  and  spleen,  will  demand  special  treatment.  In  a case  on 
record  the  irritation  of  a tape-worm  produced  a tendency  to  the  ex- 
cessive use  of  alcohol,  winch  tendency  passed  away  when  the  worm 
was  expelled. 

In  a word,  a large  majority  of  inebriates  are  diseased  persons,  and 
that  primarily  and  antecedent  to  their  inebriety,  which  is  appended 
to  and  aggravates  their  diseased  condition. 

Special  diseases,  therefore,  require  special  treatment,  irrespective 
of  the  inebriety,  if  we  would  cure  the  inebriate.  In  this  connection 
we  may  ask,  are  there  any  drugs  that  we  can  substitute  for  alcohol 
that  will  take  its  place,  and  satisfy  the  inebriate,  as  a substitute  for 
alcohol  ? 

Opium  and  the  salts  of  morphia  will  do  so  in  a marked  degree,  al- 
though cocaine,  chloral  and  the  bromides  have  been  so  used. 

The  use  of  opium  or  morphia  is  not  uncommon  among  inebriates 
who  desire  to  “ leave  off  alcohol.”  The  inebriate,  as  a rule,  is  a con- 
genital neurotic.  From  birth  almost,  he  reaches  out  for  some  drug 
that  will  gratify  or  meet  his  neurotic  craving.  The  alcohol  and  the 


ACTUAL  EFFECTS  OF  ALCOHOLIC  LIQUORS  ON  THE 
HUMAN  STOMACH  AND  KIDNEYS 

THE  KIDNEYS 


HEALTHY  CONDITION  DISEASED  FROM  INTEMPERANCE 


THE  STOMACH 


HEALTHY  CONDITION 


DISEASED  FFLOM  INTEMPERANCE 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


195 


opium  nabit  to  the  inebriate  are  convertible  habits,  and  the  inebriate, 
like  a pendulum,  will  swing  from  alcohol  to  opium  ; not  infrequently 
the  two  habits  are  combined,  as  in  the  form  of  tinct.  opii,  constitut- 
ing a mixed  habit,  in  which  the  effects  of  both  alcohol  and  opium 
have  to  be  considered.  Occasionally  a case  is  presented  in  which 
morphia  is  used  hypodermically,  and  the  alcohol  used  in  the  usual 
manner.  In  cases  where  opium  addiction  is  associated  with  the  habi- 
ttial  use  of  alcohol,  the  opium  habit  is  of  paramount  importance  and 
the  alcohol  assumes  a secondary  place. 

The  fact  that  opium  can  substitute  alcohol  is  the  keynote  to  many 
vaunted  secret  cures,  in  the  so-called  “ narcotic  treatment  ” for  alco- 
hol. It  simply  substitutes  one  habit  for  another,  and  as  long  as  the 
victim  is  taking  the  so-called  remedy  he  is  reasonably  comfortable. 
But  I admit  if  the  “ narcotic  treatment  ” was  carefully  practiced,  in 
judicious  hands  it  might,  in  conjunction  with  such  other  remedial 
measures  as  would  best  eradicate  the  primal  causes  of  the  inebriety, 
prove  useful,  if  not  curative,  in  cases  of  inebriety. 

Are  there  any  drugs  that  are  specifically  beneficial  for  the  treatment 
of  inebriety  as  such  ? We  would  state  that  drugs  that  act  directly  as 
a stimulant  to  the  nervous  system  are  of  value.  Strychnia  is  a type 
of  this  class  of  drugs,  and  one  of  the  best  of  it  class. 

Luton,  of  Rheims,  Belgium,  was  the  first  to  point  out  its  value  in 
alcoholism.  Then  the  Russians  used  it  largely  and  it  was  known  as 
the  “ Russian  treatment,”  and  finally,  the  Americans  adopted  its  use 
in  such  cases. 

Strychnia  has  proved  serviceable  as  both  abortive  and  curative  in 
acute  alcoholic  delirium,  as  well  as  useful  in  the  more  chronic  forms 
of  alcoholism.  It  seems  to  be  tolerated  in  such  cases  — in  cases  of 
alcoholic  poisoning  under  normal  conditions,  we  have  no  record  of 
the  value  of  strychnia  as  an  antidote  ; interesting  experiments  might 
be  made  on  the  lower  animals  with  the  view  of  determining  this 
point.  Strychnia  is  an  excellent  cardiac  tonic,  and  one  of  the  best 
respiratory  stimulants,  and  might  be  used  in  general  medicine  in 
cases  in  which  alcohol  is  oftentimes  prescribed. 

Oxide  of  zinc,  during  the  past  twenty  years,  has  been  used  with 
advantage  in  cases  of  chronic  alcoholic  intoxication. 

Quinine  has  been  used  more  particularly  in  the  later  or  convales- 
cent period  of  the  treatment  of  alcoholism. 

The  so-called  “ Red  Cinchona  Cure  ” for  a time  interested  the  pub- 
lic. Rational  medicine  does  not  recognize  any  special  drug  or  speci- 
fic remedy  as  a universal  cure  for  inebriety,  nor  does  clinical  experi- 
ence form  any  basis  for  such  a claim.  From  the  very  nature  of  the 
case,  such  a remedy  would  be  impossible.  The  aetiology  of  inebriety 
is  dependent  on  such  a variety  of  causes  and  its  environments  and 
complications  so  numerous  that  any  one  remedy  could  not  fulfill  all, 
or  even  meet  the  more  important  of  these  conditions.  However  val- 
uable drugs  may  be  to  meet  certain  indications  in  the  various  condi- 
tions incident  to  inebriety,  we  believe  that  so  far  as  the  curative 


196 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


treatment  of  inebriety  is  concerned,  drugs  must  assume  a secondary 
place,  valuable  as  they  may  be  in  their  respective  spheres. 

In  the  treatment  of  the  alcohol  habit  we  place  first:  Restraint  and 
seclusion  in  a special  asylum  for  a definite  period,  and  total  abstinence 
during  this  period. 

In  a few  words,  concisely  expressed,  this  statement  includes  the 
plan  now  adopted  by  the  leading  asylums  of  this  country  and  of 
Europe  for  the  recovery  of  the  inebriate.  It  involves  restraint, 
(legal,  if  need  be),  seclusion,  a special  institution,  in  which  all  the 
latest  and  best  methods  of  dealing  with  the  inebriate  are  procurable, 
a sufficient  period  in  which  to  apply  these  measures,  and  we  need 
hardly  add,  a long  period  of  total  abstinence  from  all  alcoholic  liquors. 
W e need  hardly  add  that  diet,  rest,  recreation,  hygienic  surroun^ngs, 
and  the  exhibition  of  appropriate  drugs  are  all  included  in  the  above 
plan. 

The  causes  of  degeneration  being  removed,  the  factors  of  regenera- 
tion being  brought  into  action,  new  formation  of  nerve,  muscle  and 
tissue  must  supplant  degenerated  tissue,  if  haply  organic  disease  has 
not  resulted  in  irreparable  injury. 

We  have  liinted  at  an  hysterical  element  in  the  history  of  inebriety. 
The  inebriate,  whatever  may  be  his  condition,  is  largely  influenced 
by  liis  surroundings. 

In  the  light  of  such  an  hysterical  element  in  the  clinical  history  of 
inebriety,  we  can  readily  account  for  the  apparent  success  of  the  so- 
called  temperance  movements  that  sweep  over  communities  periodi- 
cally and  effect  many  apparent  cures,  or  rather,  in  the  language  of 
the  day,  reformations.  Such  an  element  will  also  explain  why,  after 
such  a tidal  wave  of  excitement,  relapses  take  place  oftentimes  in 
large  numbers,  and  the  period  of  excitement  is  followed  by  a period 
of  reaction. 

The  occurrence  of  relapses  is  readily  accounted  for  by  the  fact  that 
the  stimulus  of  the  period  of  excitement  buoys  up  the  inebriate  for 
the  time  being,  during  which  strong  mental  emotion  is  a powerful 
factor.  He  is  keyed  up,  as  it  were,  for  the  time,  and  sustained  by  a 
moral  stimulus.  When  this  is  withdrawn,  reaction,  followed  by  cor- 
responding depression,  sets  in,  and  the  old  method  of  stimulation  is 
again  imperatively  demanded  and  yielded  to. 

Why  some  inebriates  go  through  such  a period  of  excitement  and 
do  not  relapse,  and  why  others  do,  can  be  accounted  for  by  the  fact 
that  the  former  are  in  a reasonable  degree  of  physical  health,  and  are 
not  burdened,  dragged  down  and  handicapped,  either  by  disease  that 
is  non-alcoholic,  or  that  is  the  result  of  alcoholic  degeneration.  The 
inebriates  so  affected  are  not  influenced,  or  if  at  all,  only  temporarily, 
by  the  so-called  “temperance  revivals”  that  appear  and  disappear 
with  almost  stated  regularity  in  large  and  small  communities,  and  we 
must  add  do  good,  but  only  in  the  channel  indicated. 

It  is  also  operating  through  this  hysterical  feature  of  inebriety 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


197 


that  charlatanism  may  effect  a temporary,  possibly  a permanent  suc- 
cess in  a certain  class  of  cases. 

In  cases  where  the  hysterical  element  largely  preponderates,  we  be- 
lieve psycho-therapeutical  agencies,  or  even  those  that  appeal  to 
purely  mental  conditions,  will  be  of  service,  but  they  will  not  cure  a 
cirrhosed  liver,  lung,  or  kidney,  or  remove  the  physical  causes  upon 
which  the  inebriety  may  depend.  In  addition  to  those  measures  that 
appeal  to  the  higher  moral  nature,  there  ought  also  to  be  combined 
such  as  meet  certain  intelligent  wants.  To  this  end  all  reasonable 
amusements,  entertainments,  and  especially  such  occupations  as  will 
interest  the  person  and  keep  him  busy,  should  be  encouraged,  if  not 
made  compulsory. 

Incidentally  I may  mention  hj-pnotism  as  having  been  used  espe- 
cially by  French  physicians,  with  some  benefit  in  cases  of  chronic  al- 
coholism. I have  no  data  to  give,  and  have  not  had  any  personal 
experience  with  it. 

The  Bi-Chloride  of  Gold  cure,  known  as  the  Keeley  cure,  is  in 
many  cases  successful,  but  not  in  all.  Would  advise  its  use  as  a last 
resort ; though  we  think  its  use  sometimes  leads  to  insanity  and 
suicide.  It  cures  at  all  events  for  the  time  being. 

If  the  temperance  advocates  would  supply  light,  warm,  cheerful 
places  of  resort  with  hot  and  temperance  drinks,  supplied  with  pool 
and  billiard  tables  where  the  poor  could  spend  their  evenings  and 
meet  each  other  and  amuse  themselves  at  a reasonable  expense,  and 
establish  cooking  schools  for  the  wives  where  they  could  learn  how 
to  cook  nourishing  and  palatable  food  which  would  supply  the  body 
with  the  nourishment  which  it  must  have  and  requires,  we  believe 
it  would  do  more  towards  temperance  than  all  the  laws  that  could 
be  passed. 

Many  prominent  physicians  who  have  made  alcoholism  a specialty, 
strongly  recommend  the  immediate  withdrawal  of  all  liquors,  and 
isolation  from  all  company  where  habits  and  influence  would  lead  to 
temptation,  taking  the  following  prescription  faithfully  for  three  or 
four  months: 

Sulphate  of  magnesia  ....  one  teaspoonful. 

Nitric  acid  ......  “ “ 

Sulphate  of  iron  .....  “ “ 

Powdered  cinnamon  .....  “ “ 

Sugar  of  milk  ......  three  teaspoonfuls. 

Distilled  water  enough  to  fill  a six  ounce  bottle. 

One  teaspoonful  frequently  when  the  crave  is  on,  and  in  a wine- 
glassful  of  water. 

Cold  sponge  bath  also  should  be  taken  once  or  twice  a day. 

Enlargement  of  the  Brain. — Hypertrophy. 

This  is  chiefly  a disease  of  childhood.  It  consists  in  an  unnatural 
growth  of  the  brain.  Sometimes  the  skull  grows  with  it,  and  there 
may  not  be  any,  or  only  sHght,  S3rmptoms  of  disease. 


198 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


The  complaint  is  sometimes  congenital,  — the  child  being  born 
with  a head  far  above  the  natural  standard  of  size.  Sometimes  a 
child’s  head,  from  this  disease,  will  reach  the  size  of  an  adult’s  by 
the  time  it  is  five  or  six  years  old.  This  is  not  necessarily  a disease, 
though  children  that  suffer  from  it  are  very  apt  to  die  finally  of  some 
affection  of  the  brain. 

Symptoms. — Dullness  of  intellect,  indifference  to  external  objects 
great  irritability  of  temper,  inordinate  appetite,  giddiness,  and  an  ha- 
bitual headache,  which  at  times  is  very  severe.  In  addition  to  these, 
there  are,  at  times,  convulsions,  epileptic  fits,  and  idiocy.  There  is  a 
peculiar  projection  of  the  parietal  bones,  which  serves  well  to  distin- 
guish this  disease  from  acute  hydrocephalus. 

Treatment. — As  far  as  possible,  suspend  and  repress  all  exercise 
of  the  mind.  Take  the  child  from  school  as  soon  as  the  disease  is 
discovered,  and  put  it  to  the  most  active  muscular  exercise  in  the 
open  air.  The  moment  there  is  any  excitement  of  the  brain,  or  heat 
on  the  top  of  the  head,  apply  cold  water,  ice,  or  cold  evaporating 
lotions.  If,  as  the  child  grows  up,  the  signs  of  mischief  increase,  the 
diet  must  be  simple,  and  carefully  regulated.  Bread  and  milk  only 
is  sometimes  advisable. 

Shrinking  of  the  Brain.  — Atrophy. 

This  is  a disease  in  wliich  the  volume  of  the  brain  is  diminished. 
There  are  two  forms  of  it ; one  is  congenital,  the  brain  not  being 
properly  developed  at  birth ; the  other  occurs  in  consequence  of  dis- 
ease either  in  the  membranes  or  the  arteries.  The  symptoms  are  not 
distinguishable  during  life  from  those  of  other  brain  affections,  and 
therefore  it  can  only  be  treated  according  to  general  principles. 

Water  in  the  Head. — Acute  Hydrocephalus. 

This,  like  enlargement  of  the  brain,  is  likewise  a disease  of  child- 
hood, and  often  attacks  scrofulous  children. 

Being  an  inflammatory  disease,  it  is  important  to  have  early  notice 
of  its  existence,  and,  if  possible,  to  be  aware  of  its  approach  ; which 
we  may  be,  frequently,  by  observing  the  following  premonitory 

Symptoms  ; namely,  a disturbance  of  the  digestive  functions,  indi- 
cated by  a capricious  appetite,  — the  food  at  one  time  being  disliked, 
at  another  devoured  greedily;  a foul  tongue,  offensive  breath,  enlarged 
and  sometimes  tender  belly,  torpid  bowels,  stools  light-colored  from 
having  no  bile,  or  dark  from  vitiated  bile,  fetid,  sour-smelling,  slimy 
and  lumpy.  The  child  loses  its  healthy  look,  and  grows  paler  and 
thinner.  Its  customary  spirit  and  activity  are  gone  ; it  is  heavy,  lan- 
guid, dejected ; it  is  fretful,  irritable,  uneasy ; and  sometimes  is  a lit- 
tle tottering  in  its  gait. 

After  these  warning  symptoms,  the  disease  may  begin  in  one  of 
three  ways : — 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


199 


The  pains  in  the  head  become  more  severe  and  frequent,  and  are 
sharp  and  shooting,  causing  the  little  patient  to  wake  and  shriek  out. 
As  the  drowsy  state  advances,  the  shrieking  gives  place  to  moaning. 
Beside  these  symptopis,  there  are  stiffness  in  the  back  of  the  neck, 
pain  in  the  limbs,  great  tenderness  of  the  scalp,  vomiting,  sighing, 
intolerance  of  light,  knitting  of  the  brows,  increased  disturbance  of 
stomach  and  bowels.  This  stage  may  last  ten  to  fourteen  days,  the 
child  growing  more  weak  and  peevish. 

Another  form  of  attack  is  marked  by  acute  pain  in  the  head  and 
high  fever,  convulsions,  flushed  face,  brilliant  eyes,  intolerance  of  light 
and  sound,  pain  and  tenderness  in  the  belly,  stupor,  great  irritability 
of  stomach,  causing  retching  and  vomiting  upon  every  attempt  to  sit 
up  in  bed. 

The  third  mode  of  attack  is  very  insidious,  — the  early  symptoms 
being  mild  and  hardly  noticeable,  or  not  even  occurring  at  all.  In 
such  case,  the  convulsions  or  palsy  come  suddenly,  without  notice, 
bringing  swift  and  unexpected  destruction.  This  has  sometimes  been 
called  water-stroke. 

The  First  Stage  is  the  period  of  increased  sensibility  and  excite' 
raent,  caused  by  inflammation,  in  which  the  pulse  is  quick  and  irreg- 
ular. 

The  Second  Stage  is  one  of  diminished  sensibility,  or  lethargy,  dur 
ing  which  water  is  effused  upon  the  brain,  and  the  pulse  is  slow. 

The  Third  Period  is  one  of  palsy  and  convulsions,  with  squinting 
of  the  eyes,  rolling  of  the  head,  stupor,  and  a rapid,  thread-like  pulse. 

Treatment.  — The  first  or  inflammatory  stage  of  the  fever  is  very 
important,  and  must  be  controlled  for  five  or  six  days.  Scammony  and 
croton  oil  (33)  may  be  chosen  for  this  purpose.  Apply  cold  water, 
ice,  etc.,  to  the  head.  Use  tinct.  veratrum  viride  or  (355). 

In  the  second  stage,  put  blisters  upon  the  back  of  the  neck,  and  one 
upon  the  bowels  if  they  are  very  tender. 

In  the  third  stage,  effusion  having  taken  place,  use  the  warm  bath, 
or  the  vapor  bath, . — ■ also  digitalis,  squills,  and  iodide  of  potassium, 
(144),  (128),  (302),  (130).  The  effusion,  if  permanent,  may  be 
drawn  off. 

Confine  the  child  to  a darkened  room,  of  moderate  temperature,  — 
excluding  all  noise  and  causes  of  excitement,  and  let  him  lie  upon  a 
hair  mattress,  with  his  head  somewhat  elevated. 

Diet.  — Gruel  only  during  the  stage  of  excitement,  — during  that 
of  collapse,  it  should  be  nourishing,  but  mild  and  easy  of  digestion, 
as  beef  tea,  plain  chicken  or  mutton  broth,  and  animal  jellies.  At 
the  same  time,  support  the  patient  by  the  cautious  use  of  the  aromatic 
spirit  of  ammonia,  ten  drops  every  four  hours,  valerian,  wine  whey, 
and  infusion  of  gentian,  columbo,  or  quassia,  (64),  (66). 


200 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


Dropsy  of  the  Brain.  — Chronic  Hydrocephalus. 

Acute  hydrocephalus  is  an  inflammation;  chronic  hydrocephalus, 
now  to  be  considered,  is  a dropsy.  It  often  begins  before  birth.  It 
consists  in  the  accumulation  of  enormous  quantities  of  water  within 
the  brain,  sometimes  within  its  ventricles,  at  other  times  upon  its 
surface.  When  it  occurs  soon  after  birth,  it  advances  slowly  and 
imperceptibly,  — the  enlargement  of  the  head  being  the  first  thing 
noticed. 

The  skull  being  tender  in  infancy,  it  separates  at  the  fontanelies, 
as  the  fluid  accumulates,  and  the  head,  at  times,  attains  an  enormous 
size, — so  great  that  the  child  cannot  carry  it  upright,  but  lets  it  droop 
laterally  upon  the  shoulder,  or  forward  upon  the  breast. 

As  the  disease  advances,  the  senses  become  blunted,  the  child  is 
deaf  or  blind,  the  intellect  is  weakened,  perhaps  idiocy  appears,  the 
flesh  and  strength  pass  away,  convulsions  and  paralysis  come  in  their 
turn,  and  a stupor  is  apt  to  occur  which  ends  in  death. 

Treatment.  — The  remedies  may  be  external,  or  internal,  or  both. 

Internal  Remedies.  — These  should  be  purgatives  (33),  (31),  or 
diuretics  and  alteratives  (302),  (145),  (144). 

External  Remedies.  — Apply  an  ointment  of  the  iodide  of  potas- 
sium to  the  scalp  every  night  (185).  A tight  bandage  applied  over 
the  whole  head  will  sometimes  have  a favorable  effect.  Another  ex- 
pedient is  to  puncture  the  skull  and  draw  off  the  water.  Tapping 
the  brain  has  effected  a cure  in  many  cases,  and  perhaps  promises  the 
most  relief  of  any  remedy  we  have.  In  newly-born  children  with  this 
affection,  it  is  the  best  means. 

As  may  be  expected,  none  of  these  remedies  are  likely  to  give , 
the  benefit  desired,  and  an  operative  interference  above  proposed 
constitutes  a risk  which  it  is  perhaps  better  to  run  even  if  it  results 
in  the  death  of  the  child,  rather  than  have  it  become  a hopeless 
invalid  with  epileptic  convulsions  and  the  other  manifestations  of  an 
impaired  brain. 

Cerebro=Spinal  Fever. 

Definition.  —This  disease  may  be  contracted  by  poisoned  air  and 
through  the  medium  of  fluids,  and  though  markedly  infectious,  is  not 
supposed  to  be  contagious.  The  other  names  are  spotted  fever  or 
cerebro-spinal  meningitis.  The  disease  is  found  among  children  and 
young  adults  more  often  than  among  the  aged.  It  occurs  suddenly 
in  epidemics  which  cover  a large  territory  and  it  does  not  appear  to 
be  referable  to  any  known  laws  or  atmospheric  conditions.  The 
death  rate  is  exceeding  high  considering  the  number  that  have  the 
disease,  and  this  rate  varies  during  different  epidemics  although  there 
are  different  forms  of  severity. 


DISEASES  OE  THE  BEAlN  AND  NERVES. 


201 


Symptoms. — ^As  a general  rule  the  first  symptoms  are  intense 
headache  with  pain  in  the  back  of  the  neck  or  through  the  extremi- 
ties and  chest,  followed  by  a moderate  fever  without  sweating.  Vom- 
iting, and  delirium  with  convulsions  are  common  symptoms.  In 
a small  portion  of  the  cases,  under  fifty  per  cent,  an  eruption  occurs, 
which  gives  the  name  of  Spotted  Fever  to  the  disease.  The  bending 
back  of  the  head  on  the  neck  making  it  impossible  to  bring  the  head 
forward  is  known  as  retraction  of  the  head  and  is  a very  common 
symptom.  Deafness,  blindness  and  other  complications  are  the  re- 
sult of  irritation  of  the  nervous  system.  The  disease  may  he  mistaken 
for  typhoid  fever  early  in  its  course,  though  the  bowel  symptoms  in 
the  latter  disease  are  much  more  prominent. 

Herpes  or  cold  sores  on  the  nose  and  lips  are  common  in  meningitis 
and  very  rare  in  typhoid. 

Treatment. — Cold  to  the  head  by  means  of  ice  bag  should  be  at 
once  resorted  to.  The  diet  should  be  light  and  sedatives  such  as  the 
bromide  of  soda  or  chloral  in  20  grain  doses  by  the  mouth  and  even 
morphia  in  one-fomth  grain  doses  will  be  needed  to  relieve  and  quiet 
the  nervous  irritation. 

Diseases  of  the  Spinal  Cord. 


There  are  few  diseases  more  interesting,  as  a study, 
than  those  which  affect  the  nervous  cord  which  runs 
through  the  centre  of  the  back-bone.  This  cord  is  a 
continuation,  an  appendage  or  tail  of  the  brain.  (See 
Figure  84.)  It  is  the  seat  and  centre  of  certain  ner- 
vous functions,  called  reflex,  by  which  so  many  move- 
ments take  place  which  are  not  under  the  control  of  the 
will. 

In  order  that  we  may  feel  what  takes  place  in  any 
part  of  the  body  or  limbs,  and  that  the  will  may  have 
power  to  move  such  part,  it  is  necessary  that  nervous 
matter  should  be  continuous  and  unbroken  between  the 
part  in  question  and  the  brain. 

If  the  spinal  cord  be  cut,  broken,  or  crushed  at  any 
point,  all  those  parts  which  receive  nerves  from  below 
the  injury,  lose  their  power  of  motion  and  their  feel- 
ing. When  the  injury  is  in  the  upper  part  of  the  cord, 
the  breathing  and  the  circulation  will  stop,  and  death 
is  the  immediate  consequence.  If  the  middle  portion 
of  the  cord  be  the  seat  of  the  injury,  the  bowels  and 
other  organs  may  lose  their  motion  and  feeling ; if  the 
lower  portion,  then  the  lower  limbs  only  will  be  the 
sufferers. 

Fig.  84,  Disease  or  injury  in  the  upper  part  of  the  cord  is 
therefore  much  more  dangerous  than  the  same  thing 
occurring  in  the  lower. 


202 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


Inflammation  of  the  5pinal  Cord. 

The  membranes  wHch  surround  the  cord  may  be  inflamed  just  as 
those  are  which  enclose  the  brain ; but  as  the  cavity  running  through 
the  spine  is  quite  small,  there  cannot  very  well  be  inflammation  of 
the  membranes  without  its  involving  the  cord  at  the  same  time. 

Symptoms.  — Pains,  often  intense,  running  along  the  spine,  extend- 
ing out  into  the  limbs,  and  made  worse  by  motion.  They  are  similar, 
in  some  respects,  to  rheumatic  pains.  There  is  rigid  contraction,  and 
sometimes  violent  spasms  of  the  muscles  of  the  back  and  neck,  — so 
great,  at  times,  as  to  bend  the  body  back  into  the  shape  of  a hoop ; 
also  a feeling  of  constriction  in  various  parts,  as  if  they  were  girt  by 
a tight  string;  a sense  of  suffocation;  retention  of  urine;  a most 
obstinate  constipation  and  frequent  chills  or  rigors.  The  pain  which 
is  felt  along  the  cord  is  aggravated  by  rapping  upon  the  spine,  but 
not  by  pressure. 

The  above  symptoms  are  supposed  to  be  the  result  of  inflammation 
predominating  in  the  membranes.  When  its  seat  is  more  particularly 
in  the  substance  of  the  cord,  the  symptoms  are,  — convulsive  affec- 
tions of  the  head  and  face,  inarticulate  speech,  loss  of  voice,  squint- 
ing, and  difficulty  of  swallowing,  if  the  extreme  upper  part  of  the 
cord  is  inflamed;  if  the  disease  be  slightly  lower,  difficulty  of  breath- 
ing, irregular  actiou  of  the  heart,  and  tightness  of  the  chest;  if  lower 
still,  vomiting,  pain  in  the  belly,  sensation  of  a cord  tied  round  the 
abdomen,  pain  and  heat  in  passing  water,  retention  of  the  urine,  ina- 
bility to  retain  the  urine,  desire  to  go  to  stool,  or  involuntary  stools. 

Spasm  and  stiffness,  then,  are  the  results  of  inflammation  of  the 
membranes ; convulsions  and  palsy,  of  the  same  affection  of  the  cord. 

Treatment.  — When  the  inflammation  is  acute,  apply  a few  leeches 
or  wet  cups  along  the  sides  of  the  spine.  In  chronic  inflammation, 
powerful  fi'iction,  or  mustard  draughts,  stimulating  liniments  (190), 
or  plasters,  will  generally  answer  the  purpose. 

Apoplexy. 

Apoplexy  is  that  condition  in  which  all  the  functions  of  animal 
life  are  suddenly  stopped,  except  the  pulse  and  the  breathing ; — in 
which  there  is  neither  thought,  nor  feeling,  nor  voluntary  motion  ; in 
which  the  person  falls  down  suddenly,  and  lies  as  if  in  a deep  sleep. 

Modes  of  Attack;  — There  are  at  least  three  ways  in  which  this  ter- 
rible disease  may  make  its  assault. 

The  First  form  of  attack  is  a sudden  falling  down  into  a state  of 
insensibility  and  apparently  profound  sleep,  — the  face  being  gen- 
erally flushed,  the  breathing  stertorous  or  snoring,  the  pulse  full  and 
not  frequent,  with  occasional  convulsions- 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


203 


From  this  mode  of  attack  some  die  immediately,  others  get  entiiely 
well,  and  others  get  off  with  the  exception  of  paralysis  on  one  side, 
or  the  loss  of  speech,  or  some  one  of  the  senses. 

The  Second  form  of  attack  begins  with  sudden  pain  in  the  head. 
The  patient  becomes  pale,  faint,  sick,  and  vomits,  — has  a cold  skin 
and  feeble  pulse,  and  occasionally  some  convulsions.  He  may  fall 
down,  or  may  be  only  a little  confused,  but  will  soon  recover  from  all 
the  symptoms,  except  the  headache, — this  will  continue,  and  the  pa- 
tient will  sooner  or  later  become  heavy,  forgetful,  unable  to  connect 
ideas,  and  finally  sink  into  insensibility,  from  which  he  never  rises. 

This  mode  of  invasion,  though  not  appearing  so  frightful  as  the 
first,  is  of  much  more  serious  import. 

In  the  Third  form  of  attack  there  is  sudden  loss  of  power  on  one 
side  of  the  body,  and  also  of  speech,  but  not  of  consciousness.  The 
patient  retains  his  mind,  and  answers  questions  either  by  words  or 
signs.  This  may  he  called  paralytic  apoplexy.  The  patient  may 
either  die  soon,  or  get  well,  or  live  for  years  with  imperfect  speech, 
or  a leg  dragging  after  him,  or  an  arm  hanging  useless  at  his  side. 

The  Persons  Attacked  are  apt  to  have  large  heads,  red  faces,  short 
and  thick  necks,  and  a short,  stout,  square  build,  though  it  occurs 
often  among  those  who  are  thin,  pale,  and  tall.  The  tendency  to  it 
increases  in  advanced  life. 

The  Forerunners  of  apoplexy  are  headache,  vertigo,  slight  attacks 
of  palsy,  double  vision  or  seeing  two  objects  when  there  is  but  one, 
faltering  speech,  inability  to  remember  certain  words,  sometimes  a 
sudden  forgetfulness  of  one’s  own  name,  a frequent  losing  of  the 
thread  of  ideas  attempted  to  be  pursued,  and  occasionally  an  unac- 
countable dread,  for  which  no  reason  can  be  given. 

Exciting  Causes. — Whatever  hurries  the  circulation  of  the  blood, 
as  strong  bodily  exercise,  is  an  exciting  cause.  So  are  all  those  things 
which  cause  the  blood  to  flow  towards  the  head,  as  coughing,  sneez- 
ing, laughing  and  crying,  straining  at  stool  when  costive,  lifting  heavy 
weights,  singing,  and  playing  on  wind  instruments.  To  these  may 
be  added,  exposure  to  the  sun,  the  bad  air  of  crowded  rooms,  holding 
the  head  down,  or  turning  it  around  to  look  backward,  tight  cravats 
worn  about  the  neck,  and  exposure  to  severe  cold. 

Treatment. — If  the  patient  have  the  appearance  of  suffering  from 
fulness  of  blood  in  the  head,  as  evinced  by  redness  and  turgescence 
of  the  face  and  throbbing  of  the  temporal  arteries,  and  if  the  pulse 
be  full  and  hard,  feeling  like  a tense  vibrating  rope  under  the  finger, 
place  him  in  a half-recumbent  posture,  with  his  head  raised ; loosen 
his  clothes,  particularly  his  neck-cloth  and  shirt  collar,  and  whatever 
may  press  upon  the  neck,  and  then  as  quickly  as  possible  apply  cold 
wet  cloths  to  his  head,  changing  them  often.  Ice  is  still  better,  if 


204 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


may  be  had.  Apply  wet  cups  to  the  nape  of  the  neck,  and  mustard 
draughts  to  the  soles  of  the  feet. — at  the  same  time  applying  tight 
ligatures  around  the  limbs,  to  prevent  the  blood  from  returning 
rapidly  in  the  veins.  The  ligatures  should  be  gradually  removed 
when  the  patient  recovers  his  consciousness.  Also  administer  a 
stimulating,  purgative  injection  (246),  and  place  two  drops  of  croton 
oil,  rubbed  up  with  a little  pulverized  loaf  sugar,  far  back  upon  the 
tongue.  Repeat  the  injection  every  fifteen  minutes,  till  the  bowels 
are  thoroughly  moved.  This  is  one  of  the  few  diseases  suitable  for 
bleeding. 

If  the  patient  be  old,  and  the  pulse  small  and  feeble,  with  no  ful- 
ness or  beating  of  the  temporal  arteries,  or  swelling  of  the  veins  of 
the  neck  and  forehead,  the  countenance  being  pinched,  and  the  skin 
bloodless  and  cold,  the  cupping,  purging,  and  applying  the  ligature 
must  be  omitted.  In  this  case  it  will  be  better  to  apply  warm 
flannels  and  hot  bricks  to  the  surface,  and  administer  ammonia 
and  camphor  (283),  (135)  internally. 

To  prevent  future  attacks,  gentle  tonics  should  be  used,  and  the 
skin  should  be  kept  healthy  by  daily  bathing  and  friction.  The 
bowels  must  not  be  permitted  to  become  costive.  The  diet  should 
be  light,  chiefly  vegetable,  and  almost  entirely  , so  in  hot  weather. 
The  food  should  be  well  chewed.  The  mind  should  be  kept  cheer- 
ful and  hopeful,  and  free  from  great  excitement.  The  sexual 
passion  should  be  restrained,  and  very  rarely  indulged.  Intoxicating 
drinks  should  be  abandoned,  if  used,  and  all  tight  cravats  be  dis- 
carded from  the  neck.  Direct  rays  of  the  hot  sun  in  summer  should 
be  carefully  shunned.  No  food  should  be  taken  for  three  hours 
before  retiring,  and  a mattress  only,  of  some  degree  of  hardness, 
should  be  slept  upon, — the  head  being  always  well  elevated.  To 
these  precautions,  I would  add  dipping  the  feet  every  night  before 
retiring  in  cold  water;  and,  if  any  tendency  to  cold  feet  be  ex- 
perienced, dusting  pulverized  cayenne  in  the  bottoms  of  the 
stockings. 

Sunstroke. — Coup  de  Soldi. 

Sunstroke  results  from  the  exposure  of  the  body  to  excessive  heat 
in  the  form  of  high  temperature  either  of  the  sun’s  heat,  from  a fur- 
nace, or  an  exceedingly  hot  day  from  heat  without  direct  exposure 
from  the  sun.  There  are  two  varieties,  one  known  as  heat  exhaus- 
tion, where  the  temperature  of  the  person’s  body  is  only  slightly 
elevated,  if  at  all,  the  other,  and  the  more  common  one  “heat  stroke” 
or  “sun  stroke”  in  which  the  temperature  of  the  body  is  raised  many 
degrees.  The  symptoms  are  headache,  dizziness  and  sometimes  diffi- 
cult breathing  and  thirst  in  the  earlier  stages,  which  if  not  recognized 
and  means  taken  to  prevent  more  serious  troubles,  at  once  go  into 
unconsciousness,  possibly  accompanied  by  convulsions  and  spasms. 
If  the  fever  cannot  be  reduced  a serious  condition  occurs,  followed 
probably  by  death  inside  of  twenty-four  hours.  Even  an  improve- 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


205 


ment  may  be  followed  later  by  a fatal  meningitis.  Persons  who 
have  once  had  sunstroke  are  also  greatly  afflicted  by  high  tempera- 
tures which  is  intensified  if  the  air  is  moist.  It  is  needless  to  add 
a large  portion  of  these  cases  die. 

Treatment. — As  is  known  the  normal  temperature  is  98 J degrees 
and  the  bath  is  used  to  reduce  the  temperature  as  near  this  as  possible. 
Strip  the  patient,  lay  him  flat  on  the  floor  or  low  bed  and  if  possible 
apply  ice;  ice  water  or  even  a stream  of  cold  water  from  a hose  may 
be  applied  over  the  body,  but  the  circulation  must  be  kept  up  by  an 
attendant  rubbing  the  surface  of  the  body  to  produce  reaction  so 
that  the  cooling  of  the  body  will  be  general  and  not  entirely  on  the 
surface,  as  the  congestion  of  the  body  with  heated  blood  which 
would  be  caused  if  the  rubbing  was  omitted  would  kill  the  patient. 
Ice  should  be  applied  to  the  head  by  means  of  an  ice  bag  or  some 
other  means.  Constant  care  should  be  taken  that  these  measures 
while  strenuous,  should  not  be  carried  too  far  when  the  temperature 
once  begins  to  drop,  as  when  once  started  the  patient  immediately 
goes  into  collapse  from  the  fever  dropping  too  rapidly.  Heart  stimu- 
lants such  as  teaspoonful  of  aromatic  spirits  of  ammonia  with  twenty 
drops  of  compound  spirits  of  ether  or  strychnia  in  one-thirtieth 
grain  doses  may  be  given  to  support  the  heart.  Alcohol  should  be 
avoided  as  it  will  only  increase  the  congestion  in  the  head;  some 
good  cathartic,  as  citrate  of  magnesia,  should  be  given  and  the  head- 
ache which  often  follows  may  be  relieved  by  a twenty-grain  dose  of 
bromide  with  five  grains  of  phenacetine  added;  the  recurrence  of 
high  temperature  should  be  watched  for  as  it  very  often  occurs,  when 
cold  baths  will  be  again  required,  as  a relapse  is  not  at  all  uncommon. 

Palsy.  — Paralysis. 

Palsy  is  a loss  of  the  power  of  voluntary  motion  and  feeling,  one 
or  both  coming  on,  sometimes  gradually,  but  more  often  suddenly, 
and  extending  at  one  time  to  a part,  at  another  time  to  the  whole 
body.  It  is  a kind  of  station-house  on  the  way  to  apoplexy,  where 
passengers  stop,  not  merely  to  stay  over  night,  but  to  rest  many  days, 
or  even  years. 

A great  injury  inflicted  upon  the  brain,  either  by  pressure  or  other 
cause,  will  induce  a complete  loss  of  motion  and  feeling,  and  this  ex- 
tending to  the  whole  structure,  brings  likewise  a loss  of  conscious- 
ness, which  is  apoplexy.  A smaller  degree  of  pressure,  or  a less 
injury  upon  the  same  brain,  would  occasion  a loss  of  motion  only,'  or, 
if  a loss  of  feeling  were  experienced  also,  it  would  only  extend  to  a 
part  of  the  body,  and  consciousness  would  remain.  This  would  be 
palsy.  The  disease  is  like  apoplexy  in  kind,  but  stops  short  of  it  in 
degree. 


206 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


Paralysis  of  One  Side  of  the  Body. — Hemiplegia. 

When  palsy  affects  an  entire  half  of  the  body,  dividing,  it  through 
the  centre  of  the  face,  neck,  body,  etc.,  from  head  to  foot,  it  is  called 
hemiphlegia.  It  is  more  nearly  allied  to  apoplexy  than  any  other 
form  of  the  disease,  and  is  generally  ushered  in  by  pretty  well-marked 
apoplectic  symptoms. 

Symptoms. — Sometimes  there  are  no  premonitory  symptoms ; but 
often  before  the  attack  there  are  flushed  face,  swelling  of  the  veins 
about  the  head  and  neck,  vertigo,  a sense  of  fullness,  weight,  and 
sometimes  pain  in  the  head,  ringing  in  the  ears,  drowsiness,  indistinct 
articulation  of  words,  or  even  loss  of  speech,  confusion  of  mind,  loss 
of  memory,  and  change  of  disposition,  — amiable  persons  being  made 
sullen  and  peevish,  and  irritable  ones  mild  and  simpering.  After 
the  attack,  the  countenance  generally  acquires  a vague  expression ; 
the  mouth  is  drawn  to  one  side ; the  lower  lip  on  the  palsied  side 
hangs  down,  and  the  spittle  dribbles  away.  The  speech  is  altered, 
and  the  mind  is  generally  impaired. 

In  some  instances,  the  patient  recovers  in  a longer  or  shorter  time ; 
in  others,  little  or  no  improvement  takes  place,  and  the  patient,  after 
remaining  helpless,  often  for  a long  time,  dies  either  from  gradual 
exhaustion,  or  suddenly  from  apoplexy. 

Causes. — Hemiphlegia  and  paraphlegia  are  caused  by  pressure 
upon  the  brain,  by  the  effusion  upon  it  of  blood  or  water,  by  a tumor, 
by  mechanical  injuries,  by  the  striking  in  of  eruptions,  and  by  intem- 
perance in  eating  and  drinking.  Paraphlegia  often  results  from  dis- 
ease or  injury  of  the  spinal  marrow. 

Treatment. — In  so  many  cases  does  the  administration  of  iodide  of 
potash  give  greater  or  less  relief  to  different  diseases  of  the  brain 
resulting  in  paralysis  that  its  use  is  recommended.  It  must  be  per- 
sisted in  for  weeks  and  months.  The  doses  need  not  be  excessive, 
and  five  to  ten  grains  in  a half  glass  of  water  or  milk  a day  and 
continued  some  time  will  often  be  followed  by  improvement.  There 
are  other  preparations  of  similar  nature  recommended  from  time  to 
time  but  all  depend  upon  the  amount  of  iodine  which  can  be  absorbed 
by  the  system. 

Paralysis  of  Lower  Part  of  Body. — Paraplegia. 

This  form  of  palsy  divides  the  body  transversely.,  at  the  hips,  and 
confines  itself  to  the  lower  extremities,  and  to  the  parts  about  the 
pelvis. 

Symptoms. — When  it  arises  from  affections  of  the  brain,  it  is  at- 
tended by  pain  in  the  head,  giddiness,  drowsiness,  dimness  of  sight. 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


207 


and  impaired  memory.  Numbness  is  sometimes  felt  in  the  upper  ex- 
tremities as  a forerunner  of  this  form  of  palsy.  At  first  there  is  a 
slight  stiffness  and  awkwardness  of  the  motion  of  the  legs,  which 
continue  to  increase  till  a cane  is  needed  to  balance  the  body  and 
make  it  steady.  From  a paralysis  of  the  neck  of  the  bladder,  the 
stream  of  urine  grows  more  feeble,  and  finally  dribbles  away  involun- 
tarily. The  bowels  are  for  a time  costive,  but  when  the  circular 
muscle  which  closes  the  fundament  becomes  palsied,  the  feces  pass 
■without  consent  of  the  will. 

When  disease  of  the  spinal  cord  is  the  cause  of  the  complaint,  it 
is  apt  to  come  on  gradually ; languor  and  weakness  are  felt  in  the 
knees,  the  legs  are  not  easily  directed  in  walking,  — being  thrown 
across  each  other,  causing  tripping  and  stumbling.  By  degrees  the 
loss  of  power  increases  in  the  thighs  and  legs,  until  at  length  the 
whole  lower  extremities  become  palsied  and  useless. 

Local  Palsy. 

Palsy  is  called  local  when  it  is  confined  to  a single  limb,  or  muscle, 
or  locality.  One  of  these  forms  is  caMedi  facial  pals3^  It  affects  one 
half  the  face  only,  and  is  a good  specimen  of  these  affections.  It 
removes  all  power  of  expression  from  one  half  of  the  face,  and  leaves 
the  features  still,  blank,  and  unmeaning.  With  the  affected  side  of 
the  face,  the  patient  cannot  laugh,  or  weep,  or  frown,  or  express  any 
feeling  or  emotion,  while  the  features  of  the  other  side  are  in  full 
play.  Among  the  ignorant,  who  do  not  comprehend  the  extent  of 
the  evil,  the  drollness  of  the  expression  excites  laughter. 


Shaking  Palsy. 

The  nature  of  this  form  of  palsy  is  well  expressed  by  its  name. 

Symptoms. — The  first  symptom  of  this  complaint  is  a weakness 
and  tremor  of  the  head  or  hand.  In  about  a year  the  other  hand,  or 
the  lower  extremities  become  affected ; and  the  patient  begins  to  lose 
his  balance  in  walking.  Then  the  trembling  becomes  perpetual ; no 
limb  or  part  remains  stiU..  Reading  and  writing  are  no  longer  possi- 
ble, and  the  hand  cannot  even  carry  the  food  to  the  mouth.  The 
balance  cannot  be  maintained  in  walking ; there  is  a tendency  to  fall 
forwards,  and  to  avoid  it,  the  patient  is  obliged  to  run  or  move 
quicker,  and  upon  the  toes. 

At  a later  period,  the  tremor  continues  during  sleep ; there  is  in- 
creased weakness  ; the  body  is  bent  forward,  the  speech  becomes  in- 
distinct, swallowing  difficult,  and  the  bowels  torpid.  At  last  the 
urine  and  feces  pass  involuntarily,  and  delirium  and  coma  bring  life 
to  a close. 


208 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


Lead  Palsy. 

In  this  disease  the  muscles  of  the  forearm  are  palsied,  so  that  the 
wrists  “ drop,”  as  it  is  said,  and  the  hands  hang  down  when  the  arms 
are  stretched  out.  It  is  caused  by  the  gradual  introduction  of  lead 
into  the  system.  It  is  a disease,  therefore,  peculiar  to  painters, — 
particularly  those  who  use  carbonate  of  lead,  or  white  lead,  as  it  is 
called.  It  is  generally  the  sequel  of  painter’s  colic. 

Treatment. — A sudden  and  severe  attack  of  palsy  requires  the 
same  treatment  as  apoplexy.  When  the  bowels  are  obstinately  con- 
stipated, they  must  be  moved  by  scammony  and  croton  oil  (31),  (32) 
and  by  injections  (246). 

When  all  the  symptoms  of  determination  of  blood  to  the  head  have 
disappeared,  and  the  disease  has  become  strictly  chronic,  exciting 
remedies  must  be  employed,  as  frictions,  stimulating  liniments,  blis- 
ters, stimulating  baths,  cold  affusion,  and  electricity.  Among  the  in- 
ternal remedies,  strychnine  has  the  best  reputation  (85),  (86).  The 
tincture  of  the  poison  oak  is  well  recommended  (284).  An  altera- 
tive (145)  should  likewise  be  used. 

Apply  counter-irritants  along  the  track  of  the  spine,  such  as  blis- 
ters, the  moxa,  the  compound  tar-plaster,  and  the  pitch-plaster. 

At  first  the  diet  should  be  light ; but  after  the  more  active  symp- 
toms have  disappeared,  it  should  be  nutritious,  and  sometimes  stimu- 
lating. Flannel  underclothes  should  always  be  worn  next  the  skin. 

For  lead  palsy,  the  best  remedies  are  iodide  of  potassium,  or  sul- 
phuret  of  potassium.  The  dose  of  either  of  these  is  from  three  to  ten 
grains,  three  times  a day,  dissolved  in  water,  one  ounce  of  the  salt  to 
six  ounces  of  water,  and  taken  in  simple  syrup.  The  affected  limb 
should  also  be  soaked  an  hour  each  day  in  a gallon  of  water,  with 
half  an  ounce  of  sulphuret  of  potassium  dissolved  in  it. 

Hydrophobia.  — Rabies. 

The  bite  of  the  mad  dog,  or  mad  wolf,  or  other  hydrophobic  ani- 
mal, is  the  most  dangerous  of  all  poisoned  wounds,  because  it  is  apt 
to  be  followed  by  a disease  for  which  there  is  no  certain  remedy. 
Fortunately,  the  human  subject  is  not  as  susceptible  to  the  effects  of 
the  poison  as  some  of  the  lower  animals ; for  only  about  one-tenth  of 
those  bitten  are  attacked  by  hydrophobia. 

Symptoms. — The  interval  between  the  bite  and  the  appearance  of 
the  disease  varies  from  twelve  days  to  two  months.  The  wound 
heals  like  any  other  bite  of  a similar  animal.  After  a time,  the  scar 
begins  to  have  darting,  lancinating  pains,  which,  if  it  be  a limb  that 
was  bitten,  run  up  towards  the  body.  Sometimes  it  feels  cold,  or 
stiff,  or  numb,  or  becomes  red,  swelled,  or  livid,  and  occasionally 
breaks  open,  and  discharges  matter.  The  patient  feels  a strange  anx- 
iety, is  depressed  in  spirit,  has  an  occasional  chill,  and  disturbed 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


209 


sleep,  and  spasmodic  twitches.  The  pulse  is  above  its  natural  state, 
both  in  quickness  and  strength,  and  the  nervous  system  is  very  im- 
pressible. The  senses  are  all  more  acute ; trifling  noises  produce 
agitation,  and  the  eyes  are  so  disturbed  by  the  light  that  the  patient 
sometimes  hides  himself  in  a dark  place.  The  appetite  is  lost.  This 
is  the  first  stage. 

Thirst  now  appears,  and  he  attempts  to  drink.  But  the  moment 
water  approaches  his  mouth,  a spasmodic  shudder  comes  over  him ; 
he  pushes  it  back  with  horror ; the  awful  fact  of  his  condition  flashes 
upon  him ; and  he  cries  out,  “ What  I have  dreaded  has  come  upon 
me.” 

Thenceforward  he  can  swallow  no  fluids  ; complains  of  pain  and 
stiffness  about  his  neck ; is  thrown  into  convulsions  by  the  sight  of 
water,  or  even  the  sound  of  liquids  agitated  in  a vessel,  or  by  a 
breath  of  air  blowing  upon  him,  by  a bright  light,  or  by  the  glare  of  a 
mirror.  His  throat  is  full  of  a viscid,  glary  matter,  which  he  con- 
tinually tries  to  clear  away.  Thus,  between  convulsions,  in  which 
he  struggles,  and  sometimes  strives  to  bite  his  attendants,  and  com- 
parative stillness,  during  which  he  suffers  great  depression  of  spirits, 
he  passes  three  or  four  days,  and  then  dies  either  in  a spasm,  or  from 
exhaustion. 

Treatment. — Immediate  suction  of  the  wound,  with  care  being 
taken  that  the  person  whose  lips  are  used  has  no  abrasion  or  wounds 
there,  followed  by  disinfection  is  certainly  the  best  method,  if  resort 
cannot  be  had  to  some  of  the  institutions  where  Pasteur  injective  treat- 
ment can  be  utilized.  Disinfection  may  be  carried  out  if  the  wound  is 
a torn  one,  not  a narrow  and  deep  one,  or  in  the  latter  case  it  would 
probably  be  better  to  cut  away  enough  flesh  so  that  the  disinfectant 
may  reach  the  bottom  of  the  wound.  The  use  of  corrosive  sublimate 
in  the  strength  of  one  part  to  500  of  water  applied  to  the  wound  for  five 
or  ten  minutes  and  then  a poultice  of  weak  solution  of  one  part  to  3,000 
of  water  applied  and  bound  on.  The  corrosive  tablet  sold  at  all  drug 
stores  contains  about  7 grains  of  poison,  and  dissolving  one  of  these 
in  a half  pint  of  water  makes  a strength  of  one  to  500;  a strength 
1 to  1,000  may  be  made  by  dissolving  one  tablet  in  a pint  of  water. 

Some  of  the  Western  physicians  declare  the  red  chickweed,  or  scar- 
let pimpernell,  to  be  an  absolute  remedy  for  this  disease,  and  cite 
some  quite  remarkable  cases  of  its  success.  Four  ounces  of  this 
plant,  in  the  dried  state,  are  directed  to  be  boiled  in  two  quarts  of 
strong  beer  or  ale,  until  the  liquid  is  reduced  one  half.  The  liquid 
is  to  be  pressed  out  and  strained,  and  two  drams  of  laudanum  added 
to  it.  The  dose  for  a grown  person  is  a wine-glassful  every  morning 
for  three  mornings.  A larger  dose  is  required  if  the  disease  have 
begun  to  show  itself ; and  if  the  case  be  fully  developed,  the  whole 
may  be  taken  in  a day.  The  wound  is  to  be  bathed  with  the  same 
decoction.  The  medicine,  it  is  said,  produces  profuse  sweating.  It 
is  worth  a trial. 


210 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


Considerable  has  been  said  of  late  of  a remedy  used  in  some  parts 
of  Europe,  and  said  to  be  effectual.  It  is  the  “ golden  cenotides  ” 
(cetonia  aurata),  or  common  rose-beetle,  found  in  large  quantities  on 
all  rose-trees.  A similar  insect  is  said  to  infest  the  geranium-plant. 
When  collected,  they  are  dried  and  powdered ; and  given  in  this 
form,  relieve  excitement  (so  it  is  said)  of  the  brain  and  nerves,  and 
throw  the  patient  into  a sound  sleep. 


Muscular  and  Nervous  Derangements  from 

Wounds. 

In  some  persons,  a very  small  local  injury  will  produce  violent  dis- 
turbance of  the  nervous  system.  Some  will  faint  and  be  thrown  into 
convulsions  and  vomiting  from  causes  scarcely  greater  than  the  prick 
of  a needle ; and,  before  Morton  gave  the  world  the  boon  of  ether,  it 
was  not  very  uncommon  for  persons  to  die  under  the  knife  of  the 
surgeon.  One  of  the  most  serious  disturbances  from  wounds,  of  a 
nervous  and  muscular  character,  is 

Locked  Jaw. — Tetanus. 

This  is  spasmodic  contraction,  with  rigidity,  or  stiffness,  of  the 
voluntary  muscles.  Sometimes  this  rigidity  is  partial,  at  other  times 
universal  throughout  the  system. 

Tetanus  is  produced  by  two  causes,  exposure  to  cold  (idiopathic), 
and  hodily  injuries,  particularly  the  injury  of  a nerve  (traumatic  te- 
tanus). This  last  is  the  most  frequent,  — perhaps  the  only  form  of 
the  complaint. 

The  Symptoms  are  long-continued,  violent  and  painful  contraction 
or  cramp  of  the  voluntary  muscles.  At  first  there  is  difficulty  and 
uneasiness  in  turning  the  head,  with  inability  to  open  the  mouth 
easily,  — then  the  jaws  close  gradually,  but  with  great  firmness  ; 
swallowing  now  becomes  difficult,  and  a pain,  starting  from  the 
breastbone,  pierces  through  to  the  back, — probably  caused  by  cramp 
of  the  diaphragm  or  midriff.  The  cramps  now  extend  to  the  muscles 
of  the  body,  the  limbs,  the  face,  the  tongue,  etc.,  which  continue  in  a 
state  of  rigid  spasm,  — being  swelled  and  hard  in  the  centre,  — till 
the  disease  yields,  or  the  patient  dies.  At  times  the  abdominal 
muscles  are  so  tense  as  to  make  the  belly  as  hard  as  a board.  Occa- 
sionally the  patient  is  drawn  backward  into  the  shape  of  a hoop,  so 
as  to  rest  on  his  head  and  heels  (episthotonos) ; at  other  times  he  is 
drawn  forward  in  the  shape  of  a ball  (^emprosthotonos) . All  the  con- 
tractions are  attended  with  intense  pain.  It  is  the  racking  of  the  en- 
tire body  with  cramps  like  those  which  sometimes  attack  the  calf  of 
the  leg.  So  violent  are  the  contractions  that  the  teeth  are  sometimes 
broken  by  them,  and  the  tongue  is  often  badly  bitten.  In  the  mean 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


211 


time,  the  appearance  of  the  sufferer  is  frightful.  The  forehead  is 
wrinkled,  the  brow  knit,  the  eye-balls  motionless  and  staring,  the 
nostrils  spread,  the  corners  of  the  mouth  drawn  back,  the  set  teeth 
exposed,  and  all  the  features  fixed  in  a ghastly  grin. 

The  prevention  of  tetanus  can  be  accomplished  by  thorough  disinfec- 
tion of  all  wounds,  especially  those  due  to  gun-powder  accidents  and 
implements  around  stables  and  manure  heaps. 

In  1905  the  number  of  cases  reported  following  the  July  4th  cel- 
ebration was  75  per  cent,  less  than  the  previous  year,  owing  to  pre- 
cautions taken.  It  is  so  fatal  that  somewhere  about  70  and  80 
per  cent,  of  those  who  become  affected  die.  The  most  valuable 
treatment  is  the  injection  under  the  skin  by  a competent  person 
of  the  antitoxin  of  tetanus,  but  even  this,  to  be  successful,  must  be 
administered  within  a short  time  after  the  wound  is  made  to  prevent 
the  poison  from  invading  the  nervous  system  and  causing  death. 

Treatment. — At  once  upon  the  receipt  of  a wound  which  is  sus- 
picious the  same  treatment  should  be  given  as  suggested  for  hydro- 
phobia; on  no  account  should  the  wound  be  closed  over  and  allowed 
to  heal  in  the  early  stages.  If  the  disinfectants  are  not  available  it 
is  much  better  to  leave  the  wound  exposed  to  the  air,  as  the  growth 
of  these  germs  which  is  the  cause  of  the  disease  is  increased  by  exclu- 
sion of  air.  If  the  jaw  becomes  locked  so  that  food  cannot  be  taken, 
it  may  be  necessary  to  feed  the  patient  by  means  of  a small  rubber 
tube  through  the  nostril  or  even  the  rectum,  but  a physician  will, 
of  course,  have  charge  of  the  procedure.  Ether  and  chloroform  in 
desperate  cases  may  be  inhaled  to  ease  the  final  struggle  of  the  patient, 
or  bromide  of  soda  and  chloral  in  large  doses  will  also  be  useful. 

Epilepsy. — Epileptic  Fits. 

This  disease  has  been  sometimes  called  the  falling  sickness,  but 
generally  passes  under  the  more  vague  title  of  fits. 

Symptoms. — The  disease  is  characterized  by  a temporary  loss  of 
consciousness,  strong  spasms  and  intervals  between  the  fits.  The  at- 
tack is  sudden,  generally  without  warning,  and  attended  with  a loud 
cry,  when  the  patient  falls  down,  is  senseless  and  convulsed,  struggles 
violently,  breathes  with  embarrassment,  has  a turgid  and  livid  face, 
foams  at  the  mouth,  bites  his  tongue,  has  a choking  in  the  windpipe, 
and  appears  to  be  at  the  point  of  death.  Presently,  in  from  five 
minutes  to  half  an  hour,  and  by  degrees,  these  symptoms  diminish, 
and  at  length  cease ; and  the  patient  falls  into  an  apparent  sleep.  In 
a short  time  more  he  recovers,  and  is  apparently  well.  These  attacks 
come  again  and  again,  and  at  irregular  intervals. 

This  is  the  worst  form  of  the  disease ; there  is  another  class  of 
cases  in  which  the  symptoms  are  much  lighter, — there  being  no  tur- 
gescence  of  the  face,  no  foaming  at  the  mouth,  no  cry,  no  convul- 


212 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


sions ; but  merely  a sudden  and  brief  suspension  of  consciousness,  a 
fixed  gaze,  a feeling  of  confusion,  or  a totter,  from  all  of  which  the 
recovery  is  speedy. 

Causes. — These  are  numerous,  — as  worms,  disturbance  from  indi- 
gestible food  in  the  stomach  and  bowels,  difficult  teeth-cutting,  ner- 
vous irritation,  either  direct  or  by  sympathy,  sexual  excesses  and 
masturbation,  disease  or  injury  of  the  brain  or  spinal  marrow,  gall 
stones  in  the  excretory  duct  of  the  liver,  stone  or  gravel  in  the  kid- 
neys and  bladder,  fright,  distress  of  mind,  passion,  great  loss  of  blood, 
and  many  others. 

Treatment.— But  little  can  be  done  during  the  fit,  except  to  pro- 
tect the  patient  from  being  injured  by  the  violence  of  the  convulsions 
and  especially  for  unusual  accidents  that  may  happen  while  the 
victim  is  falling  unconscious,  such  as  burying  the  face  in  the  pillow 
at  night,  choking  due  to  the  food  stopped  in  the  throat  or  falling  of 
the  body  on  hard  substances  causing  breaking  of  the  bones,  even 
fracture  of  the  skull.  There  is  little  fear  that  death  will  result.  Cures 
are  seldom  obtained  but  the  violence  of  the  convulsions  may  be  greatly 
diminished  by  proper  treatment  and  the  time  occurring  between 
attacks  of  greater  length.  The  most  important  drug  and  the  one 
tried  which  has  given  the  largest  number  of  happy  results  is  the  bromide 
of  strontium,  which  drug  as  well  as  any  chosen  must  be  used  over 
a long  period  of  time  and  even  after  the  improvement  has  been 
noticed.  The  use  of  the  drug  must  be  continued  even  over  a matter 
of  years  in  the  dosage  of  10,  20  and  even  30  grains  well  diluted  with 
water,  three  times  a day,  and  in  all  probability  an  improvement  may 
be  expected.  If  as  in  a certain  proportion  of  cases  an  attack  is  pre- 
ceded by  a premonition  of  its  onset,  the  inhalation  of  the  vapor  of 
nitrite  of  amyl  which  can  be  purchased  in  pearls,  and  crushed  in  a 
handkerchief,  the  attack  can  be  prevented. 

In  all  cases,  indeed,  the  diet  should  be  carefully  regulated,  being- 
light,  nutritious,  and  easy  of  digestion.  The  sleep  should  be  taken 
at  regular  hours,  and  daily  exercise  in  the  open  air  be  insisted  upon. 
The  bowels  must  be  kept  regular,  by  the  food,  if  possible ; if  not,  by 
mild  laxatives.  Apply  along  the  spinal  column  195,  once  a day,  rul^ 
bing  it  well  in ; also,  now  and  then,  mustard  poultices. 

In  addition  to  these  remedies,  give  pills  of  iron  and  quinine  (72). 
one  after  each  meal, — also  oxide  of  zinc  (270),  which  is  one  of  our 
very  best  remedies.  Of  the  pills,  one  should  be  taken  three  times  a 
day.  Bromide  of  sodium,  1 dram  in  24  hours,  mostly  at  bedtime. 

We  can  seldom  go  amiss  in  giving  medicine  calculated  to  relieve 
nervous  irritation,  and  to  build  up  the  general  system.  For  this  pur- 
pose, the  valerianate  of  quinine,  and  the  extract  of  black  cohosh  (7 9) 
are  well  adapted.  Citrate  of  iron  and  strychnine  (316),  is  a very  val- 
uable remedy. 

It  is  said  that  a black  silk  handkerchief  thrown  over  the  face  of  a 


DISEASES  OF  THE  BEAIN  AND  NERVES.  213 

person  in  a fit,  will  immediately  bring  them  out  of  it.  It  is  an  ex- 
periment easily  tried ; and  having  seen  it  in  a respectable  medical 
journal,  I give  it  for  what  it  is  worth.  The  bromides  in  large  doses, 
long-continued,  sometimes  cure  epilepsy  (367). 


Catalepsy.  — Trance. — Ecstasy. 

Cataleptic  fits  are  simply  what  is  known  to  all  the  world  under 
the  name  of  trance;  and  ecstasy  is  a modification  of  the  same  nervous 
disorder.  It  is  a state  in  which  the  mind  becomes  so  intensely  ab- 
sorbed in  something  outside  of  its  earthly  tenement,  that  it  withdraws 
all  control  over  the  body,  and  all  apparent  connection  with  it,  leav- 
ing it  as  if  dead.  There  is  a very  light  ticking  of  the  heart,  just  per- 
ceptible to  a cultivated  ear,  but  the  breast  does  not  rise  and  fall  with 
breathing,  the  features  are  all  inexpressive  and  still,  the  eyes  are  wide 
open  and  motionless,  apparently  staring  after  the  departed  intellect ; 
and  the  body  and  limbs  are  entirely  passive, — remaining  unmoved 
where  they  are  placed  by  others,  however  tiresome  and  uncomfortable 
the  position.  In  a word,  a person  in  catalepsy  is,  in  appearance,  like 
a marble  statue,  or  like  a human  body  suddenly  turned  to  stoDe,  or, 
like  Lot’s  wife,  to  a pillar  of  salt.  There  is  as  little  feeling,  oi* 
thought,  or  consciousness,  as  if  the  bowl  had  been  instantaneously 
broken  at  the  cistern,  and  the  apparent  death  were  real. 

It  is  a peculiarity  in  this  disease  that  the  patient,  on  recovery 
from  a fit,  takes  up  the  thread  of  conscious  life  just  where  it  was 
broken  by  the  attack.  Thus,  if  she  were  lifting  a cup^  of  water  to 
the  mouth,  she  would  hold  it  steadily,  with  the  mouth  open,  till  the 
return  of  consciousness,  and  then  place  it  to  the  lips,  as  if  no  inter- 
ruption had  occurred ; or,  if  conversing,  and  in  the  midst  of  a sen- 
tence, the  unfinished  words  would  be  uttered  at  the  end  of  the  fit, 
even  though  it  should  last  many  days. 

Persons  in  a cataleptic  fit  have  much  the  appearance  of  one  in  the 
mesmeric  state  ; and  the  statue-like  position  in  which  an  attack  fixes 
a patient,  reminds  one  of  the  manner  in  which  the  psychologists,  so 
called,  will  arrest  a man  under  their  influence,  and  make  him  im- 
movable, with  one  foot  raised  in  the  act  of  stepping. 

The  disease  attacks  females  much  more  often  than  males. 

The  premonitory  symptoms  are  much  like  those  of  epilepsy,  and 
the  treatment  should  be  about  the  same. 

Saint  Vitus’s  Dance.  — Chorea. 

This  disease  is  chiefly  conflned  to  children  and  youth  between  the 
ages  of  eight  and  fourteen.  But  few  cases  occur  after  puberty. 

Symptoms. — The  complaint  affects  mostly  the  muscles  and  the 
limbs.  It  excites  curious  antics, — such  as  we  should  suppose  would 
occur  if  a part  of  the  muscles  of  voluntary  motion  had  hatched  a 
mimic  rebellion,  broken  away  from  the  control  of  the  will,  and  in 


214 


DISEASES  OF  THE  BRAIN  AND  NERVES.'" 


sheer  mischief  and  wantonness,  were  tripping  their  fellow  muscles, 
and  playing  tricks  with  the  patient.  A few  of  the  muscles  of  the 
face  or  limbs  begin  their  mischievous  pranks  by  slight  twitches, 
which,  by  degrees,  become  more  energetic,  and  spread  to  other  parts. 
The  face  is  twisted  into  all  kinds  of  ridiculous  contortions,  as  if  the 
patient  were  making  mouths  at  somebody.  The  hands  and  arms  do 
not  remain  in  one  position  for  a moment.  In  attempting  to  carry 
food  to  the  mouth,  the  hand  goes  part  way,  and  is  jerked  back,  starte 
again,  and  darts  to  one  side,  then  to  the  other,  then  mouth  ward 
again ; and  each  movement  is  so  quick,  and  nervous,  and  darting, 
and  diddling,  that  ten  to  one  the  food  drops  into  the  lap.  If  the  at- 
tempt be  made  to  run  out  the  tongue,  it  is  snatched  back  with  the 
quickness  of  a serpent’s,  and  the  jaws  snap  together  like  a fly-trap. 
The  lower  limbs  are  in  a state  of  perpetual  diddle ; the  feet  shuffle 
with  wonderful  diligence  upon  the  floor,  as  if  inspired  with  a cease- 
less desire  to  dance. 

It  is  supposed  by  some  that  the  disease  consists  in  a partial  palsy 
of  a part  of  the  muscles.  The  will  in  that  case  not  being  able  to 
control  the  palsied  muscles,  when  it  commands  the  others  to  move, 
their  action  is  not  balanced,  and  they  twitch  the  face  and  limbs  into 
all  the  capricious  and  fantastic  shapes  we  witness. 

Others,  and  probably  with  more  truth,  hold  that  the  seat  of  the 
disease  is  in  the  cerebellum  or  little  brain.  It  is  supposed  to  be  one 
of  the  functions  of  this  organ  to  preside  over  and  regulate  the  loco- 
motion,— that  it  holds  the  office  of  chief  engineer,  and  that  its 
duties  are  to  keep  the  muscles  in  subjection  to  the  will.  The  com- 
bined and  consenting  action  of  several  muscles  is  needed  for  every 
movement.  It  is  the  business  of  the  cerebellum  to  maintain  this 
oneness  of  purpose  and  action  — to  see  that  no  muscle  flinches  so  as 
to  disturb  the  harmony  of  the  movement.  When  the  cerebellum  is 
diseased,  all  is  confusion, — just  as  the  locomotive  runs  from  the 
track  when  the  engineer  is  smitten  with  palsy. 

The  disease  is  not  dangerous,  but  when  it  continues  for  many 
years  it  is  apt  to  weaken  the  mind,  and  it  sometimes  very  nearly 
destroys  it. 

Causes. — Whatever  excites  and  weakens  the  nervous  system,  as 
powerful  emotions  of  the  mind,  overworking  the  mind,  reading  ex- 
citing novels,  eating  too  much  meat,  fright,  striking  in  of  eruptions, 
self-pollution,  etc. 

Treatment. — In  the  first  place,  remove  all  causes  of  excitemait. 
Take  the  patient  from  school,  and  require  some  sort  of  cheerful  out- 
door exercise,  daily.  Take  away  all  books,  and  be  careful  not  to  do 
anything  to  occasion  anger  or  fear,  or  any  kind  of  injurious  excite- 
ment. Apply  spinal  ice-bags  gradually  and  regularly. 

In  the  second  place  regulate  the  diet  — making  it  more  animal 
and  stimulating  if  it  has  been  too  low,  and  more  vegetable  and  cool- 
ing if  it  has  been  too  high. 


DISEASES  OF  THE  BRAIH  AND  NERVES. 


215 


In  the  third  place,  if  the  above  changes  have  not  been  sufficient 
for  the  purpose,  open  and  regulate  the  bowels  with  some  gentle 
physic  (30),  (34)  for  a few  days. 

Iron  in  the  form  of  tincture  of  the  chloride  of  iron,  10  drops 
in  water  taken  through  a tube  after  meals,  and  arsenic  in  the  form 
of  Fowler’s  solution  must  be  used  for  the  ansemia,  which  is  so  often 
present.  This  latter  drug  is  a strong  solution  of  arsenic  and  must  be 
used  with  great  care,  given  in  a dose  for  a young  child  2 or  3 drops 
well  diluted  with  water  three  times  a day,  gradually  increasing  a 
drop  a day  up  to  8 to  10  drops  three  times  a day,  which  is  the  maximum 
amount;  it  is  not  safe  to  increase  more.  The  danger  of  poisoning  must 
be  looked  for,  such  as  a puffiness  about  the  eyes  and  nose,  or  pains  and 
cramps  in  the  stomach.  They  show  that  the  patient  is  getting  a 
little  more  than  is  sufficient.  The  drug  should  then  be  cut  down 
about  half  and  continued  at  the  last  amount  or  entirely  stopped.  If 
there  is  a rheumatic  history  the  salicylate  of  soda  in  5 to  10  grain 
doses  three  times  a day  must  be  used.  Next  to  arsenic,  sedatives, 
such  as  bromide  of  soda  or  hyoscyamus  or  better  than  all  the  fluid 
extract  of  cimicifuga  in  the  doses  of  half  a teaspoonful  diluted  with 
water  twice  a day  often  proves  a help. 

To  these  remedies  should  be  added  the  shower-bath,  beginning 
with  tepid  water,  and  making  it  a little  colder  every  day.  If  the 
shower-bath  frightens  the  patient,  or  is  not  otherwise  well  borne,  take 
the  sponge  bath. 

Chronic  Chorea. 

This  can  hardly  be  said  to  amount  to  a disease.  It  consists  rather 
in  uncouth  tricks,  arising  from  some  slight  disorder  of  particular 
muscles,  and  grown  into  a fixed  habit,  such  as  shaking  of  the  head 
every  three  to  twenty  seconds,  repeated  squinting  of  the  eyes  in  con- 
nection with  a peculiar  knitting  of  the  eyebrows,  wrinkling  of  the 
nose,  shrugging  of  the  shoulders,  lifting  the  ears  up  and  down,  or 
even  moving  the  whole  scalp  back  and  forth.  These  movements  are 
commonly  made  without  a consciousness  of  it ; and  generally  there 
is  no  power  to  suspend  them  without  a painful  effort  which  cannot 
be  easily  continued. 

No  medical  treatment  is  of  any  avail.  These  tricks  can  only  be 
corrected  by  great  watchfulness  and  effort  on  the  part  of  the  person 
suffering  from  them,  and  in  many  cases,  not  even  by  such  means. 

Cramps. 

Cramp  is  experienced  -n  the  calves  of  the  legs,  the  thighs,  the 
stomach,  the  breast,  the  Avomb,  etc.  It  is  a A’ery  painful,  sudden,  and 
violent  contraction  of  one  or  more  muscles.  The  part  is  sometimes, 
as  the  phrase  is,  “ drawn  up  into  knots.”  When  it  attacks  the  stom- 
ach, it  is  a very  dangerous  affection.  Women  are  subject  to  it  about 
the  third  or  fourth  month  of  pregnancy. 


216 


DISEASES  OF  THE  BEAIN  AND  NERVES. 


They  occur  more  frequently  at  night  as  the  result  of  over-fatigue 
and  indigestion  during  the  day.  These  spasmodic  contractions  often 
occur  in  the  abdomen  and  are  accompanied  by  diarrhoea  due  to  indi- 
gestion. Abdominal  cramps  are  also  a symptom  of  locomotor  ataxia 
and  other  spinal  diseases.  The  cramp  of  swimming  is  often  due  to 
an  over-straining  of  some  one  group  of  muscles  not  hitherto  much 
used,  the  sudden  fatigue  causing  cramp.  They  may  be  also  of  ner- 
vous origin.  Rheumatism  is  not  infrequently  the  sole  cause  of  pain- 
ful musculax  spasms. 

Causes. — Drinking  cold  water  when  very  hot  and  perspiring,  ex- 
posure to  damp  night  air,  debility,  indigestible  food,  and  excesses  in 
eating  and  drinking,  and  particularly  over-straining  the  muscles. 

Treatment. — Moderate  the  excessive  labor  and  straining  of  the 
muscles  which  produce  the  cramps.  When  an  attack  occurs  in  the 
legs,  tie  a cord  or  handkerchief  tight  around  the  leg  above  the  af- 
fected muscle.  This  will  generally  produce  instant  relief.  Also 
briskly  rub  the  parts  with  hot  water,  alcohol,  ammonia,  spirits  of  cam- 
phor, paregoric,  or  laudanum. 

When  it  occurs  in  the  stomach,  apply  warm  fomentations,  or  what 
is  better,  a mustard  paste  (165).  Take  hot  Jamaica  ginger  or  neuro- 
pathic drops.  The  bowels,  if  confined,  should  be  opened  with  an  in- 
jection. 

Cramps  of  the  limbs  which  afflict  women  in  the  family  way,  can 
only  be  mitigated,  not  cured,  till  after  confinement.  As  a palliative, 
high  cranberry  bark,  scullcap,  etc.  (87),  will  be  found  useful. 

Pain  of  the  Nerves.  — Neuralgia. 

This  disease  affects  one  tissue  only, — the  nervous ; and  has  one 
symptom, — ])ain. 

In  apoplexy.,  the  nerves,  rendered  powerless  and  senseless  by  an  ex- 
ternal force,  are  like  a man  under  a bank  of  earth  which  has  slid 
down  upon  him.  In  palsy,  they  are  suddenly  bereft  of  feeling  and 
motion  by  a blasting  scourge  within, — as  one  is  smitten  down  hy  a 
pervasive  charge  from  a magnetic  battery.  In  epilepsy,  the  nerves 
are  grasped  and  for  a time  held  senseless  by  an  unseen  power,  in 
which  they  struggle,  as  a man  strives  in  the  folds  of  the  anaconda. 
In  catalepsy,  they  are  suddenly  stiffened  into  senseless  strings,  for 
such  automatic  use  as  the  bystander  may,  for  the  time,  choose  to 
make  of  them.  In  chorea,  they  are  set  to  dancing  by  an  invisible  ex- 
hilaration, as  a man  is  suddenly  crazed  by  brandy. 

In  neuralgia,  the  nerves  are  neither  crushed,  nor  collapsed,  nor  re- 
strained for  a time,  nor  stiffened,  nor  exhilarated.  They  simply  have 
their  sense  of  feeling  intensely  exalted ; they  are  filled  with  pain. 
The  pain  is  generally  of  a peculiarly  darting,  piercing  character.  The 
patient  sometimes  calls  it  tearing  pain.  It  comes  on  in  sudden  par- 
oxysms, with  intervals  of  freedom  between.  The  attacks  are  some- 


DISEASES  OF  THE  BRAIN  AND  NERVES,  217 

times  like  an  electric  shock,  and  are  so  agonizing  as  to  bring  a tern* 
porary  loss  of  reason.  Occasionally  there  is  great  tenderness  of  the 
parts  affected,  and  some  fulness  of  the  blood-vessels  in  the  neighbor- 
hood ; but  generally  the  signs  of  inflammation  are  all  absent,  except 
pain. 

Neuralgic  pains  occur  in  almost  every  part  of  the  system.  One  of 
the  most  familiar  forms  of  the  disease  is  known  under  the  name  of 

Tic  Douloureux. 

It  occurs  in  those  branches  of  the  fifth  pair  of  nerves  which  go  to 
the  face.  (See  Fig.  85.)  Sometimes 
one,  sometimes  all  of  the  three  branches 
are  affected,  but  more  often  the  middle 
branch  only.  When  the  upper  branch 
is  the  seat  of  the  disease,  the  pain  is  in 
the  forehead,  the  brow,  the  lid,  and  some- 
times the  ball  of  the  eye.  The  eye  is 
generally  closed  during  the  pain,  and 
the  skin  of  the  forehead  is  wrinkled. 

When  the  affection  is  in  the  middle 
nerve,  the  pain  is  preceded  by  a prick- 
ing sensation  in  the  cheek,  and  twitch- 
ing of  the  lower  eyelid.  Soon  it  spreads 
in  quick  and  piercing  pangs  over  the 
cheek,  reaching  the  lower  eyelid,  the 
sides  of  the  nostrils,  and  the  upper  lip. 

If  in  the  lower  branch,  it  sends  its  light- 
ning shafts  to  the  chin,  the  gums,  the 
tongue  and  even  up  the  cheek  to  the  ear. 

Face-Ache. — There  is  a species  of  nervous  pain  called  face-ache^ 
which  does  not  quite  amount  to  tic  douloureux,  but  is  nevertheless 
very  afflictive.  It  occurs  principally  in  the  jaw,  which  seems  to  be 
filled  with  pain.  No  one  spot  seems  to  be  more  affected  than  another. 
From  the  jaw  the  pain  often  goes  to  the  whole  head,  but  it  has  not 
the  stabbing  intensity  which  generally  characterizes  neuralgia.  It 
often  proceeds  from  defective  teeth. 

Hemicrania. 

This  is  a neuralgic  pain,  confined  to  one  side  of  the  head, — gen- 
erally the  brow  and  forehead.  Sickness  of  the  stomach  often  attends 
it,  and  in  many  cases  it  is  periodical, — coming  on  at  a certain  hour 
every  day,  and  lasting  a given  time,  and  then  passing  away. 

It  may  be  caused  by  whatever  debilitates  the  system,  as  hysterics, 
suckling  an  infant  too  long,  or  low  diet.  In  fever  and  ague  districts 
it  is  frequently  produced  by  miasm.  In  many  instances,  the  cause 
cannot  be  discovered. 


218 


DISEASES  OF  THE  BRAIN  AND  NERVES. 

Sciatica. 

This  is  a pain  beginning  at  the  hip,  and  following  the  course  of 
the  sciatic  nerve.  Occasionally  it  is  an  inflammatory  complaint ; 
sometimes  is  connected  with  an  affection  of  the  kidney;  but  fre- 
quently it  is  a purely  neuralgic  or  nervous  pain ; and  I have  there- 
fore thought  it  best  to  place  it  here,  with  nervous  diseases. 

Besides  the  various  forms  of  neuralgia  now  noticed,  the  disease 
occurs,  — sometimes  with  great  severity,  — in  the  female  breast,  in 
the  womb,  in  the  stomach,  in  the  bowels,  in  the  thighs,  in  the  knee, 
and  even  in  the  feet.  In  many  of  these  cases  the  disease  is  not  where 
the  pain  is  felt,  but  in  the  brain  or  spinal  marrow,  and  consequently 
the  true  source  of  the  complaint  very  often  escapes  detection.  An 
excellent  Episcopal  clergyman  in  Northern  New  York,  the  Bev.  M. 
B — — , with  whom  I studied  Latin  and  Greek  preparatory  to  college, 
had  a neuralgic  pain  in  the  knee  so  intense,  persistent  and  exhausting, 
that  the  limb  had  to  be  cut  off  at  the  thigh  to  save  his  life. 

Treatment. — This  must  be  as  diversified  as  the  causes  of  the  dis- 
ease. For  a general  B use  368. 

For  tic  douloureux,  and  some  other  forms,  give  internally,  valerian- 
ate of  ammonia  (88);  also  89,  90,  91,  92,  93,  316,  and  84,  as  tonics. 

For  external  use  in  tic  douloureux,  and  other  neuralgic  affections, 
the  prescriptions  188,  196,  197,  198. 

For  the  face-ache,  above  mentioned,  muriate  of  ammonia  (134),  in 
half  dram  doses,  is  a very  valuable  remedy. 

When  the  disease  is  caused  by  miasm,  and  has  a periodic  character, 
like  ague,  it  must  be  treated  with  quinine  (67),  (79),  and  if  there  he 
a low  state  of  the  blood,  iron  (72),  (93)  must  be  given  at  the  same 
time.  The  galvanic  battery  often  acts  like  magic  in  neuralgia. 

The  shower-bath,  exercise  in  the  open  air,  and  whatever  else  will 
build  up  the  general  health,  must  be  used  according  to  circumstances. 

Neuralgic  pain  of  various  kinds  often  yields  readily  to  some  one  of 
the  many  coal-tar  products  like  phenanthrene,  antikamnia  and  ammo- 
nol:  say  10  grains  of  either  every  two  to  four  hours  according  to  the 
intensity  of  the  pain.  The  last  named  product  is  quite  harmless  and 
produces  no  numbness  or  faintness  which  is  said  to  follow  at  times 
the  use  of  some  of  the  others. 

Avoid  rich  or  fatty  foods.  Live  on  a plain  nourishing  diet.  Take 
exercise  out  of  doors  as  much  as  possible. 

Derangement  of  Mind.  — Insanity. 

Most  writers  on  this  disease  have  attempted  a definition  of  it.  I 
have  never  seen  one  which  suited  me.  Here  is  mine.  Insanity  is  a 
wrench  of  man's  nature,  which  sets  his  intellectual  and  moral  faculties 
nwry  in  their  relations  with  the  external  ivorld. 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


219 


In  a state  of  mental  and  moral  health,  he  looks  straight  at  the  out- 
ward world,  and  sees  it  as  it  is  ; insanity  gives  him  an  angular  con- 
nection with  it  and  he  sees  it  as  it  is  not;  its  objects  have  all  changed 
their  relative  places ; objects  at  the  right  in  the  panorama  of  life  have 
moved  to  the  centre,  or  gone  quite  over  to  the  left ; while  things  at 
the  top  have  gone  to  the  bottom,  and  those  in  the  lowest  places  have 
taken  the  highest.  With  the  thoroughly  insane,  the  world  has  gone 
bach  to  chaos. 

These  persons  have  their  sensibility  very  much  altered  and  per- 
verted. Errors  of  the  senses  and  illusions  cheat  them.  In  many 
cases,  they  cannot  read  because  the  letters  are  mingled  in  a confused 
mass.  They  often  do  not  recognize  their  friends,  and  regard  them 
as  strangers  or  enemies. 

They  become  awkward  in  the  mechanical  use  of  their  hands,  and 
their  touch  loses  the  power  to  correct  the  errors  of  the  other  senses. 
Hence  they  are  cheated  in  regard  to  the  size,  form,  and  thickness  of 
bodies. 

They  are  haunted,  at  times,  with  smells  which  have  no  existence, 
and  they  hear  voices  distinctly  speaking  to  them  from  clouds,  or  from 
trees ; and  these  voices  have  the  familiar  tones  of  a friend,  relative, 
or  enemy. 

The  insane  lose  the  power  of  comparing  ideas.  They  associate 
things  the  most  unlike,  and  often  in  a ridiculous  way. 

They  also  lose  the  control  of  themselves,  and  come  under  the  do- 
minion of  their  passions  ; and  then  they  will  do  acts  which  they  them- 
selves disapprove.  One  of  strict  integrity,  of  unblemished  morals,  and 
of  excellent  standing,  becomes  insane,  and  immediately  steals  what  he 
does  not  want,  makes  infamous  proposals,  and  indecent  gestures,  and 
is  in  every  respect  the  opposite  of  his  past  self. 

The  insane  often  become  averse  to  those  who  were  previously 
among  the  most  dear  to  them.  For  acts  of  kindness,  they  repay 
abuse.  They  fly  from  their  best  friends.  This  is  the  result  of  their 
fear  and  jealousy ; for  they  are  very  cowardly  and  jealous.  This  alien- 
ation from  friends  is  almost  a characteristic  of  insanity,  and  is  one  of 
its  saddest  features.  The  moral  affections  are  always  disordered,  per- 
verted, or  annihilated  in  insanity.  So  much  is  this  a leading  feature 
of  the  disease,  that  it  is  only  when  the  insane  begin  to  recover  their 
moral  affections,  when  they  begin  to  wish  to  see  their  children  and 
friends,  to  fold  them  once  more  in  their  arms,  and  to  enter  the  family 
circle  and  renew  its  joys,  that  we  can  count  upon  any  certain  signs 
of  a cure. 

The  insane  have  a thousand  strong  fancies  in  regard  to  themselves. 
One  thinks  himself  inspired  of  God.  and  charged  with  the  conversion 
of  the  world ; while  another,  equally  sincere,  believes  the  devil  has 
entered  into  him,  and  that  the  pains  of  hell  are  already  taking  hold 
of  him,  and  he  curses  God,  himself,  and  the  universe.  Still  another 
is  the  “ monarch  of  all  he  surveys,”  and  much  more ; he  governs  the 


220 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


world,  and  directs  the  stars.  One  has  all  knowledge,  and  affects  to 
teach  the  wisest.  Another  is  proud,  and  withdraws  from  his  fellows, 
bidding  them  not  to  come  into  his  presence  without  proper  acts  of 
homage, — calling  himself,  it  may  be,  a king. 

There  are  five  kinds  of  insanity.  I will  speak  of  each  of  them 
briefly. 


Melancholy.  — Lypemania. 

This  is  characterized  by  moroseness,  fear,  and  prolonged  sadness. 
The  melancholic  person  is  lean  and  slender,  with  black  hair,  and  a 
pale  and  sallow  countenance.  His  skin  is  brown  or  blackish,  and 
dry  and  scaly.  His  physiognomy  has  a fixed  appearance,  the  muscles 
of  the  face  are  drawn  tight,  the  eyes  are  motionless,  and  directed  to 
one  point,  the  look  is  askance  and  suspicious,  and  the  general  expres- 
sion is  one  of  sadness,  fear,  and  terror.  He  desires  to  pass  his  days 
in  solitude  and  idleness.  He  walks  as  if  aiming  to  shun  some  dan- 
ger. His  eye  and  ear  are  on  the  watch  for  evil. 

These  persons  do  not  sleep  much.  They  are  kept  awake  by  fear, 
jealousy,  and  hallucinations.  If  their  eyes  close,  they  see  phantoms 
which  terrify  them. 

Their  secretions  are  disordered.  The  urine  is  either  abundant  and 
clear,  or  scanty  and  muddy.  They  sometimes  retain  their  urine  for 
days.  One  patient  did  not  dare  to  make  water  lest  he  should  drown 
the  world,  but  was  finally  persuaded  to  it  by  the  assurance  that  he 
would  extinguish  a fire  which  was  devouring  a city. 

Insanity  on  One  Subject. — Monomania. 

This  is  a chronic  affection  of  the  brain,  not  attended  by  fever,  and 
characterized  by  a derangement  of  the  intellect,  the  affections,  or  the 
will,  upon  one  subject  only.  The  patient  seizes  upon  a false  princi- 
ple, and  draws  from  it  injurious  conclusions,  which  modify  and  change 
his  whole  life  and  character.  In  other  cases  the  intellect  is  sound, 
but  the  affections  and  disposition  being  perverted,  their  acts  are 
strange  and  inconsistent.  These  they  attempt  to  justify  by  plausible 
reasoning. 

Mania. 

This  is  also  a chronic  affection  of  the  brain,  generally  without 
fever.  The  countenance  of  the  maniac  is  sometimes  flushed,  at  other 
times  pale.  The  hair  is  crisped  ; the  eyes  injected,  shining  and  hag- 
gard. Maniacs  dislike  the  light,  and  certain  colors  horrify  them. 
Their  ears  are  sometimes  very  red,  and  are  disturbed  by  a tingling, 
and  a rumbling  sound.  Noise  excites  and  disturbs  them.  They  suf- 
fer from  false  sensations,  illusions  and  hallucinations;  and  their  ideas 
come  with  great  rapidity,  and  are  confused  and  without  order.  , Their 


DIBEA.SES  OF  THE  BRAIN  AND  NERVES. 


221 


affections  are  in  a state  of  turmoil,  and  their  judgments  are  all  erro- 
neous. 

Unlike  the  monomaniac,  their  delirium  extends  to  all  subjects. 
Their  entire  intellect,  affections  and  will,  are  a chaotic  wreck. 

Dementia. 

Hebe  is  another  chronic  affection  of  the  brain,  without  fever,  in 
which  the  sensibility,  the  intellect,  and  the  will,  are  all  weakened. 
Demented  persons  have  not  the  power  to  concentrate  their  minds  on 
anything,  and  can  form  no  correct  notions  of  objects.  Their  ideas 
float  after  each  other  without  connection  or  meaning.  They  speak 
without  any  consciousness  of  what  they  are  saying. 

Many  of  them  have  lost  their  memory,  or,  like  old  persons,  they 
remember  nothing  recent, — forgetting  in  a moment  what  is  just  said 
or  done. 

The  demented  have  neither  desires  nor  aversions ; neither  hatred 
nor  love.  To  those  once  most  dear  to  them,  they  are  totally  indif- 
ferent. They  meet  friends  long  absent  without  emotion,  and  part 
from  their  dearest  ones  without  a pang.  The  events  of  life  passing 
around  them  awaken  in  them  no  interest,  because  they  can  connect 
themselves  neither  with  the  past  nor  the  future ; they  have  no  remem- 
brances nor  hopes.  Their  brain  is  inactive  ; it  furnishes  no  ideas  or 
sensations.  They  are  no  longer  active,  but  passive  beings  ; they  de- 
termine nothing,  but  yield  themselves  to  the  will  of  others. 

They  have  a pale  face,  a dull  eye,  moistened  with  tears,  an  uncer- 
tain look,  and  a physiognomy  without  expression.  They  sleep  pro- 
foundly, and  for  a long  time,  and  have  a voracious  appetite. 

Idiocy. 

Idiocy  is  in  the  condition  in  which  the  intellectual  faculties  have 
never  been  manifested.  We  are  not  to  infer  disease  from  it,  any  more 
than  we  infer  it  in  the  lower  animals  from  the  absence  of  intellect. 

In  idiocy  there  is  no  mind,  because  the  brain  is  not  large  enough 
to  be  the  organ  of  intelligence.  It  always  dates  back,  therefore,  to 
the  beginning  of  life.  Everything  about  the  idiot  betrays  a defective 
organization.  The  demented  person,  the  monomaniac,  etc.,  once  had 
intelligence  ; the  idiot,  never.  They,  in  many  cases,  may  be  cured  ; 
he  is  hopelessly  incurable.  They  had  blessings  which  have  been  taken 
from  them ; to  him,  none  were  ever  given.  They  were  once  the  pride 
and  hope  of  their  friends ; he,  from  his  birth,  was  the  smitten  and 
blasted  one  of  his  family.  He  never  reaches  an  advanced  age, — 
rarely  living  beyond  thirt3'‘  years.  * 

These  remarks  are  sufficient  to  show  the  difference  between  idiocy 
and  other  forms  of  mental  derangement.  In  the  other  forms  of  in- 
sanity there  are  brains  enough,  but  they  are  diseased  ; in  this  there  is 
no  disease ; the  smallness  of  the  brain  is  the  primal  and  fatal  defect. 


222 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


This  form  of  mental  derangement  is  caused  by  a defective  develop- 
ment of  the  brain.  That  the  other  forms  are  produced  by  disease  of 
the  brain,  there  can  be  no  doubt. 

Some  have  supposed  insanity  to  be  a mental  disorder  merely,  hav- 
ing nothing  to  do  with  the  body.  They  might  as  well  suppose  the 
delirium  of  fever  to  be  a disease  of  the  mind  only. 

Insanity  is  an  unsoundness  of  the  brain  and  nerves  which  proceed 
from  it,  in  every  instance.  At  first  it  is  probably  only  excitement  of 
the  brain ; but  this,  long  continued,  becomes  a chronic  inflammation. 
The  brain  and  nerves  of  an  insane  person  are  undoubtedly  sore,  and 
hence  the  painful  thoughts  and  feelings  which  afflict  them.  When 
the  soreness  is  much  increased,  they  are  violent  and  furious ; when 
it  subsides,  they  are  calm.  In  consequence  of  this  inflammation  and 
soreness  of  the  brain,  an  insane  person  can  no  more  think,  or  reason, 
or  will,  or  feel  correctly,  than  a person  with  an  inflamed  stomach  can 
digest  food  well,  or  than  one  with  inflamed  eyes  can  see  well. 

Causes  of  Insanity. — Hereditary  predisposition;  painful  subjects 
of  thought  or  feeling  long  revolved  in  the  mind ; injured  feelings 
which  cannot  be  resented,  mortified  pride,  perplexity  in  business ; 
disappointed  affection  or  ambition  ; great  political,  religious,  or  social 
excitements ; sudden  and  heavy  strokes  of  misfortune  in  the  loss  of 
property  and  friends ; and  in  general,  whatever  worries  the  mind  for 
a long  time,  and  creates  a deep  distress,  may  be  a cause  of  insanity. 

But  one  of  the  most  prolific  causes,  and  worthy  of  special  mention, 
is  masturbation,  or  self-pollution, — a vice  contracted  by  thousands  of 
young  people,  both  male  and  female. 

Besides  the  above,  I may  mention  several  physical  causes,  as  con- 
vulsions of  the  mother  during  gestation,  epilepsy,  monthly  disorders 
of  women,  blows  upon  the  head,  fevers,  loss  of  sleep,  syphilis,  exces- 
sive use  of  mercury,  worms  in  the  bowels,  and  apoplexy. 

Chances  of  Cure. — Idiotism  is  never  cured. 

Melancholy  and  monomania  are  cured  when  recent,  and  do  not  de- 
pend upon  organic  disease. 

Dementia  is  sometimes,  though  seldom,  cured. 

Chronic  insanity,  of  long  standing,  is  not  easily  cured. 

Insanity  which  has  been  produced  by  moral  causes,  acting  suddenly, 
is  generally  curable ; if  the  causes  have  acted  slowly  and  long,  the 
cure  is  more  doubtful. 

Excessive  study  causes  insanity  which  is  hard  to  cure. 

If  caused  or  continued  by  religious  ideas,  or  by  pride,  it  is  not 
often  cured. 

Insanity  caused  and  maintained  by  masturbation  is  cured  with 
great  difficulty. 

Treatment.— The  treatment  of  the  insane  is  now  almost  confined, 
as  it  should  be,  to  public  hospitals.  In  these  institutions,  all  the 
means  are  provided  which  humanity  has  been  able  to  devise,  to  lift 


DISEASES  OF  THE  BRAIN  AND  NERVES: 


223 


from  these  unfortunate  beings  the  terrible  shadow  which  is  upon 
them.  Here  they  have  safety,  comfort,  recreation,  friendly  guardians, 
rest,  and  medicine. 

They  have  safety  from  the  annoyances  which  well-meaning  but 
mistaken  friends  at  home  almost  always  commit  in  contradicting,  and 
reasoning  with,  persuading,  and  threatening  them ; for  only  in  these 
humane  institutions  has  it  been  well  learned  that  to  do  so  is  no  wiser 
than  to  persuade,  scold,  or  threaten  a neuralgic  pain  in  the  face,  an 
inflammation  in  the  stomach,  or  a felon  upon  the  finger.  They  are 
safe,  too,  from  the  impertinent  scrutiny  of  neighbors,  the  hootings  of 
unthinking  boys  in  the  streets,  and  especially  from  the  causes,  what- 
ever they  are,  which  have  produced  the  disease.  And  so  far,  this  is 
just  the  treatment  they  want, — no  contradiction,  no  impertinent 
scrutiny  from  neighbors,  no  abuse  in  the  streets,  and  a withdrawal  of 
the  causes  which  have  produced  the  disease. 

In  these  institutions,  too,  they  have  comforts.  They  have  clean 
rooms,  galleries,  lodges,  bathing-rooms,  yards  and  gardens  for  exer- 
cise and  walking,  safe,  quiet,  well-aired  bed-rooms,  and  clean  and 
comfortable  beds  ; cheerful  dining  rooms,  and  plain,  wholesome,  and 
nutritious  food.  And  this,  likewise,  is  the  treatment  they  require. 

They  have  recreation,  — dances,  cards,  back-gammon,  chequers, 
chess,  billiards,  nine-pins,  walking  parties,  riding  parties,  gardening, 
and  an  indulgence  in  those  arts  of  painting,  music,  drawing  and 
architecture  for  which  they  may  have  a taste.  And  such  recreations 
are  powerful  instruments  in  the  cure  of  all  disorders  of  the  nervous 
system. 

Here,  too,  they  have  friendly  guardians,  who  have  long  studied 
their  complaints,  and  have  imbued  their  souls  with  a sympathy  which 
goes  down  into  the  depths  of  their  sufferings,  and  allies  itself  with  all 
their  sorrows  ; — men  and  women  who  are  willing  to  act  the  part  of 
guardian  angels ; to  be  their  friends ; who  know  how  to  gain  their 
confidence ; and  who  use  the  influence  acquired  by  love,  in  leading 
them  back  towards  health  and  happiness.  And  this,  too,  in  curing 
the  insane,  is  of  great  consequence,  for  none  can  do  them  good  till 
they  have  their  confidence,  and  this  can  be  gained  only  by  love  and 
wisdom. 

In  these  insane  asylums,  they  find  rest.  When  the  brain  is  hot 
from  inflammation,  and  they  are  raving  from  delirium,  they  are  here 
withdrawn  from  the  noisy  crowd,  and  shielded  from  the  rude  shocks 
of  the  world.  If  need  be,  they  are  placed  in  solitary  rooms,  where 
silence  spreads  its  soothing  stillness  through  their  excited  brains. 
And  it  is  of  the  greatest  importance  that  the  sore  and  torn  feelings 
should  rest ; for  rest  allays  excitement,  and  brings  sleep ; and  with- 
out a proper  amount  of  sleep  recovery  is  not  possible. 

Finally,  in  these  institutions,  they  receive  the  best  medical  treat- 
ment. They  have  warm  and  cold  bathing,  judiciously  administered; 
they  have  simple  cathartics  when  the  bowels  are  bound,  as  salts,  cas- 


224 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


tor  oil,  and  magnesia ; tonics  for  debility,  such  as  quinine,  iron,  cas- 
sia, columbo,  chamomile ; and  quieting  medicines  for  their  excite- 
ment, such  as  opium,  morphine,  cicuta,  hyoscyamus,  belladonna,  stra- 
monium, scullcap,  and  valerian.  Prescription  74  is  a combination 
much  used.  Here,  too,  broth,  gruel,  and  milk,  are  administered  by 
the  forcing  pump  to  such  as  take  a fancy  not  to  eat,  — an  expedient 
which  has  saved  many  lives.  Fruits  of  all  kinds,  as  strawberries, 
cherries,  currants,  plums,  apples,  peaches,  and  grapes,  are  allowed 
freely.  Cold  water,  sweetened  or  otherwise,  is  the  drink.  To  these 
things  are  added  lively  conversation,  and  whatever  will  divert  the 
mind  from  reflection,  and  internal  imaginings  and  revery. 

Thus  I have  indicated,  very  briefly,  the  treatment  which  the  insane 
receive  in  public  institutions.  That  the  chances  of  recovery  in  these 
humane  retreats  is  much  greater  than  at  home,  does  not  admit  of  a 
doubt.  When  it  is  not  convenient  to  send  an  insane  person  to  a hos- 
pital, the  treatment  should  be  as  near  like  the  one  here  sketched  as 
circumstances  will  permit. 


Hypochondria. 

The  common  names  of  this  disease  are  low  spirits^  spleen^  vapors, 
nypo,  and  the  blues.  It  produces  constant  fear,  anxiety,  and  gloom. 
Business,  pleasures,  the  acquisition  of  knowledge,  and  all  the  useful 
pursuits  of  life,  become  insipid,  tasteless,  and  even  irksome  to  the  hy- 
pochondriac. His  mind  is  full  of  the  belief  that  something  dreadful 
is  about  to  befall  him.  He  is  either  going  to  be  sick,  or  to  die,  or 
lose  his  property  or  friends.  He  has  no  mind  to  engage  in  any  busi- 
ness, nor  does  he  wish  to  go  anywhere,  or  to  see  anybody.  Night 
and  day  his  spirits  are  down  to  zero,  and  his  heart  has  a load  too 
heavy  to  bear.  He  is  wholly  occupied  with  his  troubles  and  his  feel- 
ings. He  thinks  he  has  various  diseases,  and  wears  out  his  friends 
by  talking  of  his  sufferings.  He  feels  of  his  pulse  often,  looks  at  his 
tongue  in  the  glass,  and  several  times  a day  asks  a friend  if  he  does 
not  look  pale  or  sick. 

The  external  senses  manifest  symptoms  of  derangement  as  well  as 
the  thoughts,  feelings,  emotions,  and  passions.  There  are  roarings  in 
the  ears,  like  a waterfall,  or  the  noise  of  a distant  carriage.  Floating 
black  specks,  or  bright  sparks,  are  seen  before  the  eyes.  These  indi- 
cate a slight  fulness  of  the  blood  vessels,  and  perhaps,  in  some  in- 
stances, sparks  of  electricity  passing  to  or  from  the  eye,  and  are  in  no 
proper  sense  subjects  for  the  alarm  they  cause.  At  one  time  the  per- 
son will  feel  as  large  as  a barrel,  at  other  times  not  larger  than  a 
whip-stock;  the  head  will  feel  light  or  heavy,  large  or  small.  The 
skin  will  twitch  in  different  parts,  or  feel  numb,  or  have  the  sensation 
of  spiders  crawling  on  it.  The  smell  and  taste  become  perverted ; 
the  hypochondriac  will  smell  odors  and  flavors,  at  times,  where  there 
are  none. 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


225 


These  errors  of  the  senses  are  all  owing  to  some  slight  disorder  of 
the  organs  of  sense ; and  they  are  no  more  wonderful  than  that  the 
mind  should  perceive  personal  danger,  poverty,  and  death  itself,  when 
none  of  these  things  are  impending. 

These  persons  are  subject  to  fainting  turns,  when  the  breathing 
will  appear  to  stop,  the  body  become  cold,  the  face  pale ; there  will 
be  distress  in  the  region  of  the  heart,  which  will  apparently  stop  beat- 
ing, and  the  person  will  feel  as  if  dying.  At  the  same  time  the  mind 
will  remain  clear.  These  nervous  spells  are  alarming,  but  pass  off 
without  danger. 

These  persons  become  changed  in  their  moral  dispositions.  They 
are  jealous,  take  a joke  as  an  affront,  and  feel  the  greatest  distress  at 
any  apparent  lack  of  attention  or  neglect  on  the  part  of  friends. 
They  put  the  worst  construction  upon  the  actions  of  friends.  They 
are  irritable,  fretful,  peevish,  and  fickle. 

The  complaint  is  distressing,  but  does  not  appear  to  shorten  human 
life. 

The  seat  of  the  disease  is  in  the  brain  and  nerves.  It  is  caused  by 
anxiety,  care,  disappointment,  working  the  brain  too  hard,  diseases  of 
the  liver  and  stomach,  costiveness,  sedentary  habits,  excessive  vene- 
real indulgence,  and  masturbation. 

Treatment. — This  disease  is  more  easily  prevented  than  cured.  It 
would  be  almost  entirely  prevented  in  this  country  if  in  childhood  we 
were  all  taught  to  be  contented  with  humble  competence,  to  love  ac- 
tive labor,  and  to  think  it  honorable,  instead  of  struggling  after 
wealth,  and  falling  into  unhappiness  when  it  does  not  come. 

Remedies. — Of  all  the  remedies  for  this  complaint,  that  which  is 
most  important  is  active  employment  out  of  doors.  The  human  body 
was  made  for  motion.  Without  it  the  blood  cannot  be  distributed  to 
the  several  organs.  The  senses,  — the  eye,  the  ear,  the  touch, — 
should  be  much  in  communion  with  nature.  In  this  way  they  are 
strengthened.  Nature  is  their  great  physician.  Man  is  a creature  of 
sensation;  and  if  too  much  occupied  with  feelings,  thoughts,  and  deep 
reflections,  the  nerves  will  be  irritated,  and  begin  to  give  deceptive 
sensations.  A very  nervous  man  should  fly  to  some  active  occupa- 
tion, if  he  would  be  rid  of  suffering. 

The  open,  fresh  air  is  very  important  to  restore  the  system  to 
soundness. 

Temperance,  both  in  eating  and  drinking,  will  do  much  for  this 
class  of  patients,  yet  they  are  the  very  persons  who  eat  largely,  and 
they  often  fly  to  the  excessive  use  of  stimulants  to  drive  away  their 
sorrow.  By  so  doing,  they  aggravate  the  disease. 

Amusements  are  very  important  for  hypochondriacs.  Lively  com- 
pany, cheerful  and  witty  conversation,  with  mirth  and  laughter,  lively 
songs  and  instrumental  music,  are  all  desirable ; and  so  are  gunning, 
fishing,  riding,  billiard-playing,  and  travelling. 


226 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


Never  allow  these  patients  to  be  alone,  and  to  have  time  to  brood 
over  their  misery.  See  that  they  go  early  to  bed,  and  rise  betimes  in 
the  morning.  The  warm  bath,  the  cold  shower,  or  sponge  bath,  with 
brisk  friction,  are  not  on  any  account  to  be  omitted.  The  diet  should 
be  light,  nutritious,  and  generous  ; but  fats,  acids,  liquors,  and  coffee, 
must  be  forbidden. 

But  little  medicine  will  be  required.  If  there  be  costiveness,  let 
cracked  wheat  be  eaten;  if  this  does  not  answer,  a little  rhubarb 
and  bicarbonate  of  potassa  (35),  or  leptandrin,  podophyllin,  etc.  (36), 
may  be  given  as  required  by  the  symptoms.  A teaspoonful  of  cal- 
cined magnesia  once  a day,  or  the  infusion  of  thoroughwort,  drank 
cold,  will  often  answer  an  excellent  purpose.  A bowl  of  warm 
motherwort  tea,  with  a teaspoonful  of  spirits  of  camphor  in  it  will  do 
well  in  fits  of  fainting  when  there  is  a sensation  of  dying.  A tea- 
spoonful of  sulphuric  ether  maybe  given  at  the  same  time.  If  there 
be  debility,  tonics  are  sometimes  useful  (50),  (49),  (54),  (55). 

Hiccough. — Singultus. 

This  is  a sudden,  jerking  spasm  of  the  midriff,  occurring  every  few 
moments  in  bad  cases,  causing  the  air  to  be  driven  out  of  the  lungs 
with  such  suddenness  as  to  produce  a noise  something  like  the  invol- 
untary yelp  of  a puppy.  It  is  generally  caused  by  acidity  of  the 
stomach,  which  irritates  the  nerves  distributed  to  its  neighborhood, 
and  is  not  difficult  to  remove ; but  when  it  occurs  towards  the  close 
of  some  acute  and  grave  disease,  it  is  sometimes  a sign  that  dissolu- 
tion is  at  hand. 

Treatment. — Startle  the  person  suffering,  by  exciting  surprise,  or 
fear,  or  anger ; or  let  a few  small  draughts  of  cold  water  be  taken  in 
quick  succession;  or,  let  the  breath  be  held  as  long  as  possible.  If 
the  stomach  is  sour,  take  a teaspoonful  of  bicarbonate  of  soda,  dis- 
solved in  half  a tumblerful  of  cold  water.  To  expel  wind  from  the 
stomach,  if  it  be  present,  take  some  warm  aromatic  essence  of  pep- 
permint, ether,  or  compound  spirits  of  lavender.  But  one  of  the 
most  effectual  remedies  is  heavy  pressure  made  upon  the  collar  bones. 
It  is  simple,  and  very  effectual.  Cocaine,  one-eighth  grain  every  fif- 
teen minutes,  is  a very  simple  and  often  efficacious  remedy. 

Fainting.  — Syncope. 

Fainting  is  preceded  by  a distress  about  the  heart,  a swimming 
of  the  head,  sometimes  sickness  at  the  stomach,  coldness  of  the  hands 
and  feet,  and  a loss  of  sight,  or  a sense  of  things  growing  dark.  The 
breathing  diminishes,  the  pulse  becomes  small,  the  face  deadly  pale, 
and  the  patient  wilts  down,  and  becomes  more  or  less  unconscious  of 
what  is  passing  around. 

Whatever  causes  debility,  particularly  of  the  nervous  system,  will 


DISEASES  OF  THE  BRAIN  AND  1<^RVES. 


227 


predispose  to  fainting.  Persons  much  weakened  by  disease,  faint 
easily,  especially  when  they  attempt  to  stand  still.  When  on  their 
feet,  such  persons  should  keep  moving.  Fainting  is  sometimes  in- 
duced by  sudden  surprises  and  emotions,  by  violent  pains,  by  the 
sight  of  human  blood,  and  by  irritation  of  the  coats  of  the  stomach 
by  indigestible  food. 

Treatment. — Lay  the  patient  upon  the  back, with  the  head  low ; let 
fresh  air  into  the  room  instantly,  and  apply  gentle  friction.  Sprinkle 
a little  cold  water  upon  the  face,  and  hold  spirits  of  camphor,  ether, 
hartshorn,  or  vinegar  to  the  nose,  — rubbing  a little  of  the  spirits  of 
camphor  upon  the  forehead,  and  about  the  nostrils.  As  soon  as  the 
patient  can  swallow,  give  a teaspoonful  of  compound  spirits  of  lav- 
ender, with  ten  drops  of  water  of  ammonia  in  it. 

Persons  subject  to  fainting  should  not  go  into  crowded  assemblies 
where  the  air  is  bad  ; neither  should  they  wear  tight  dresses,  or  allow 
themselves  to  get  excited.  Cold  bathing,  a well-regulated  diet,  and 
vegetable  tonics,  will  do  much  to  break  up  the  habit. 

Dizziness  of  the  Head.—  Vertigo. 

This  affection  makes  objects  which  are  stationary  appear  as  if 
moving,  or  as  the  phrase  is,  “ turning  round.”  When  seized  with  it, 
one  will  have  a sensation  as  if  falling,  and  objects  about  him  will 
seem  to  be  in  motion. 

It  is  caused  by  irritation  of  the  nerves  of  the  stomach  in  dyspep- 
sia, by  long  application  of  the  mind,  by  a weakened  nervous  system, 
by  hysterics,  and  by  a fulness  of  the  blood-vessels  of  the  head. 
When  it  proceeds  from  most  of  these  causes,  it  is  not  dangerous  ; but 
when  caused  by  impending  apoplexy,  it  is  a symptom  of  very  serious 
import. 

Treatment. — Find  out  the  cause  and  remove  that,  and  the  dizzi- 
ness will  disappear.  If  it  come  from  dyspepsia,  eat  lightly ; if  from 
costiveness,  open  the  bowels  either  by  coarse  food,  by  daily  cold 
water  injections,  or  by  some  gentle  physic.  Avoid  coffee,  ardent 
spirits  and  late  suppers,  and  take  much  exercise.  Keep  the  feet 
warm,  and  the  head  cool.  See  to  the  liver  and  heart. 

Disturbed  Sleep.  — Nightmare.  — Incubus. 

In  this  complaint  the  sleep  is  disturbed  generally  by  some  fright- 
ful image.  Whatever  of  an  alarming  character  is  presented  to  the 
mind  in  sleep,  causes  fear,  or  some  other  painful  emotion,  the  same 
as  when  awake.  And  when  the  attempt  is  made  to  resist,  or  to  flee 
from  the  danger,  it  is  ineffectual,  because  the  muscles  are  locked  fast 
in  sleep.  The  fear  being  increased  by  the  inability  to  escape,  the 
sleeper  makes  all  sorts  of  horrible  noises,  indicating  distress  of  mind. 
The  danger  seen  is  as  real  to  the  sleeper  as  if  he  were  awake,  and  he 


228 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


tries  to  do  just  what  he  would  if  awake.  Sometimes  the  sensation  is 
that  some  heavy  weight,  or  perhaps  some  horrible  monster,  is  upon 
the  breast,  nearly  pressing  the  breath  out  of  the  body. 

At  times,  the  power  of  motion  is  not  absent,  and  then  disturbed 
dreams  may  cause  one  to  talk,  or  to  rise  and  walk,  or  run.  Children 
will  laugh  or  cry,  or  scream,  which  shows  that  their  minds  are  agi- 
tated by  different  passions.  Persons  who  indulge  gloomy  and  troub- 
lous thoughts  in  their  waking  hours  are  apt  to  be  disturbed  with 
sleep-walking,  sleep-talking,  and  frightful  dreams,  as  of  falling  down 
precipices,  during  the  hours  for  repose. 

There  is  nothing  very  wonderful  about  these  disturbances  of  sleep. 
It  is  only  necessary  that  there  should  be  an  unusual  sensitiveness  of 
the  brain,  or  that  a hearty  supper,  eaten  late,  should  irritate  the 
nerves  of  the  stomach,  and  that  distressing  thoughts  should  be  dwelt 
upon  during  the  day  and  evening,  in  order  to  produce  all  the  walk- 
ing, talking,  dreaming  of  hobgoblins,  shipwrecks,  fires  and  polar 
bears,  which  distress  so  many  unfortunate  sleepers. 

In  night-walking  there  is  simply  a little  more  wakefulness  than  in 
night-talking,  and  in  this  latter,  more  than  when  one  falls  from  a high 
place,  and  in  this  perhaps  slightly  more  than  in  real  incubus^  when 
one  is  in  the  greatest  peril,  but  cannot  move  at  all. 

Treatment, — When  sleeping  persons  groan,  or  make  any  noise 
indicating  nightmare,  shake  them,  and  they  will  come  out  of  it  at 
once.  As  these  troubles  are  often  caused  by  a weakened  state  of 
the  nerves,  much  outrdoor  exercise  should  be  taken.  The  diet  should 
be  simple,  and  well  regulated.  The  suppers  should  be  light,  and 
never  taken  late.  The  evening  should  be  spent  in  some  pleasant 
amusement,  which  will  drive  away  care ; and  the  last  hours  of  wake- 
fulness be  occupied  with  pleasant  reflections.  One  afflicted  with 
nightmare  should  not  lie  upon  the  back,  nor  with  the  hands  over  the 
head.  Acidity  of  the  stomach,  and  costiveness,  if  they  exist,  should 
be  removed  by  neutralizing  mixture. 

Headaches. 

These  are  not  always  caused  by  disorders  of  the  brain  and  nerves, 
but  they  frequently  are,  and  this  seems  the  proper  place  to  speak  of 
them. 

It  is  unwise  ever  to  neglect  headaches.  They  are  sources  of  great 
suffering,  and  often  lead  to  serious  derangements  of  the  health.  In 
childhood  they  have  a more  serious  meaning  than  in  adult  life. 
They  often  indicate  the  approach  of  scarlet  fever,  or  measles,  or  of 
other  diseases. 

Headaches  are  more  common  among  the  civilized  than  the  uncivil- 
ized ; more  frequent  among  females  than  among  males ; among  those 
of  sensitive  feeling  than  among  the  more  obtuse ; among  those  who 
think  much  than  among  those  who  think  little ; among  the  sedentary 
than  among  the  active. 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


229 


Causes  of  Headaches.  — They  are  dependent  on  various  causes, 
as  derangement  of  the  circulating  system,  of  the  digestive  organs,  of 
the  nervous  system,  etc.  Among  those  dependent  on  disturbance  of 
the  circulation,  are 

Headaches  from  Eye  Diseases.  — Myopia,  or  near-sightedness ; 
Hypermetropia,  or  far-sightedness ; Astigmatism,  or  the  inability  to 
see  equally  well  horizontal  and  vertical  lines,  as  well  as  other  irreg- 
ularities of  vision,  are  frequent  sources  of  headache.  These  head- 
aches are  caused  by  overtaxing  certain  groups  of  muscles,  or  by  fixing 
the  eyes  too  long  on  one  objective  point,  as  experienced  in  prolonged 
study  or  reading,  especially  under  unfavorable  circumstances.  These 
headaches  are  more  or  less  similar  in  their  symptomatology.  The 
ache  is  generally  dull,  situated  mostly  in  forehead  and  over  eyes,  but 
may  also  be  spread  from  base  of  brain  to  the  eyes  ; oftentimes  it  is 
accompanied  by  nausea,  especially  after  prolonged  use  of  eyes  under 
improper  conditions. 

The  treatment  of  these  headaches  consists  in  absolute  rest  of  the 
eye,  in  ease  of  overwork,  and  the  fitting,  by  a competent  oculist,  of 
such  glasses  as  will  rectify  the  irregularity  in  the  eye  proper. 

Astigmatism  is  a common  source  of  headaches,  and  often  is  so  in- 
sidious in  its  development  as  to  escape  attention.  A rough  test 
may  be  made  by  drawing  several  horizontal  and  several  vertical 
lines  in  close  proximity,  and  then  placing  at  some  distance  (15  to  20 
feet)  from  the  eye.  If  either  set  cannot  be  as  clearly  seen  without 
blurring  as  the  other,  you  have  good  cause  to  suspect  Astigmatism, 
and  should  consult  an  oculist.  Do  not  dally  with  these  eye-head- 
aches, as  you  will  be  doing  a permanent  injury  to  your  eyes. 

Tea  and  Coffee  Headaches.  — In  the  nervous,  and  oftentimes  in 
the  gouty  and  rheumatic  person,  the  use  of  tea  or  coffee  will  cause 
violent  headaches.  Tobacco  likewise  after  prolonged  use  shows  a 
tendency  to  headaches.  These  luxuries  of  life  should  be  discontin- 
ued at  once  for  at  least  one  month.  An  extra  strong  cup  of  black 
coffee,  to  be  sure,  will  stop  the  headache  for  the  time  being,  but  only 
adds  fuel  to  the  fire  in  the  long  run.  Bromo-caffeine,  as  ordinarily 
sold  by  the  druggists,  taken  in  teaspoonful  doses  every  half  hour, 
will  relieve  the  malady.  We  would  strongly  advise  a,nyone  that  has 
constant  or  periodical  headaches,  if  he  uses  either  tea  or  coffee,  and 
especially  coffee,  to  leave  them  off  entirely  for  three  months.  It  may 
he  the  sole  cause,  and  if  caused  by  tea  or  coffee,  there  is  no  possi- 
bility of  their  cure  by  medicines  while  you  continue  their  use. 

Plethoric  Headaches. — These  are  dependent  on  a general  fulness 
of  blood.  They  are  of  two  kinds.  One  is  occasional,  and  lasts  but 
a few  hours.  The  other  lasts  for  days  or  weeks.  It  occurs  most 
often  in  the  night  or  morning.  Persons  whose  occupations  require 
stooping  have  it  most.  A little  dizziness  is  generally  felt  on  rising 
up  from  a stooping  posture.  It  is  brought  on  by  the  bad  air  of 


230 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


crowded  rooms,  and  is  attended  by  costive  bowels,  short  breath,  and 
a white  furred  tongue. 

The  persistent  headache  is  accompanied  by  a sense  of  fulness,  and 
sometimes  of  throbbing  over  the  brows  and  temples,  with  a sensation 
of  dizziness,  and  of  mist  before  the  eyes.  The  sufferer  fears  exertion 
and  is  constantly  looking  for  a rush  of  blood  to  the  head.  Nature 
sometimes  relieves  this  form  of  headache  by  a diarrhoea,  or  by  bleed- 
ing from  the  nose. 

There  is  another  form  of  plethoric  headache,  differing  slightly  from 
the  above,  in  which  there  is  too  much  blood,  and  it  is  made  too  fast, 
but  it  does  not  circulate  so  rapidly.  The  muscles  are  not  very  firm, 
and  the  heart  does  not  propel  the  blood  with  much  force.  This  form 
of  headache  is  connected  with  congestion. 

Headaches  of  Indigestion.  — These  are  caused  either  by  taking 
improper  articles  of  food,  or  by  eating  too  much  of  those  which  are 
proper.  The  sensation  in  the  head  is  not  always  a pain,  but  some- 
times only  a dull  weight,  attended  by  languor  and  disinclination  for 
exertion ; a tongue  white  in  the  centre,  and  pale  red  at  the  tip  and 
edges ; cold  and  numb  fingers  ; slight  nausea ; languid  and  feeble 
pulse ; dim  and  indistinct  sight ; eyes  aching  when  employed ; and 
difficulty  in  fixing  the  attention. 

Sick  Headache.  — This  has  received  its  name  from  the  constant 
nausea  or  sickness  at  the  stomach  wliich  attends  the  pain  in  the 
head. 

This  headache  is  apt  to  begin  in  the  morning,  on  waking  from  a 
deep  sleep,  or  after  sleeping  in  a close  room,  and  when  some  irregu- 
larity of  diet  has  been  committed  on  the  day  before,  or  for  several 
previous  days.  At  first  there  is  a distressingly  oppressive  feeling  in 
the  head,  which  gradually  merges  into  a severe,  heavy  pain  in  the 
temples,  frequently  attended  by  a sense  of  fulness  and  tenderness  in 
one  eye,  and  extending  across  the  forehead.  There  is  a clammy,  un- 
pleasant taste  in  the  mouth,  an  offensive  breath,  and  the  tongue  cov- 
ered with  a yellowish-wliite  fur.  The  sufferer  desires  to  be  alone, 
and  in  the  dark.  The  hands  and  feet  are  cold  and  moist,  and  the 
pulse  feeble. 

Accompanying  these  symptoms,  there  is  a depressing  sickness  at 
the  stomach,  which  is  increased  by  sitting  up,  or  moving  about. 
After  a time,  vomiting  comes,  and  relief  is  obtained. 

Bilious  Headache.  — This  is  most  common  in  summer  and  au- 
tumn. It  afflicts  persons  of  dark  complexion  with  black  hair  and 
melancholy  dispositions.  There  are  two  kinds,  one  is  due  to  an  ac- 
cumulation of  bile  in  the  system ; the  other,  to  a large  secretion  of 
bile. 

In  the  first  variety  the  skin  is  dingy  and  sallow,  the  spirits  de- 
pressed, the  bowels  costive,  and  there  is  wind  in  the  stomach,  with  a 
dull,  aching  pain  on  the  right  sboulder.  The  pain  is  in  the  forehead, 


DISEASES  OF  THE  BEAIN  AND  NERVES. 


231 


eyebrows  and  eyelids,  and  the  “ white  of  the  eye  ” is  a little  yellow- 
ish. The  tongue  has  a brown  fur,  and  is  cracked  in  the  centre. 
There  is  a bitter  taste  in  the  mouth  on  waking  in  the  morning,  after 
restless  nights,  and  frightful  dreams. 

In  the  second  variety,  which  is  due  to  an  “ overflow  of  bile,”  the 
symptoms  are  much  like  those  of  the  first  kind,  but  the  pain  is  not  so 
continuous.  In  addition  to  the  symptoms  named,  there  is  a throb- 
bing, rending  pain  in  the  head,  the  skin  is  hot  and  the  face  flushed, 
the  limbs  are  sore,  and  there  is  a luminous  halo  or  ring  around  ob- 
jects looked  at,  and  a feeling  of  giddiness. 

Nervous  Headaches.  — These  are  more  common  among  females 
than  males.  They  occur  most  frequently  among  persons  of  high  sus- 
ceptibility, who  are  easily  elevated,  and  as  easily  depressed.  They 
are  often  connected  with  indigestion. 

The  pain  is  usually  acute  and  darting,  and  is  made  worse  by  light, 
with  a feeling  as  if  the  temples  were  being  “ pressed  together,”  and 
a “ swimminess  ” in  the  head.  There  is  sometimes  a sense  of  sink- 
ing, with  a dread  of  falling,  and  great  despondency  and  restlessness. 
The  bowels  are  generally  costive,  and  the  sight  dim.  The  pain  comes 
on  most  commonly  in  the  morning,  lasts  through  the  day,  and  abates 
in  the  evening. 

Hysteric  Headache. — There  is  a nervous  headache  dependent  on 
the  hysterical  condition.  It  is  generally  confined  to  one  small  spot, 
frequently  over  the  eyebrow,  and  is  sometimes  compared  to  a wedge 
or  nail  driven  into  the  skull. 

Headache  from  Exhaustion.  — Still  another  species  of  nervous 
headache  arises  from  extreme  exhaustion,  produced  by  great  loss  of 
blood,  by  diarrhoea,  or  by  over-suckling.  The  pain  is  generally  on 
the  top  of  the  skull,  and  is  often  compared  to  the  beating  of  a small 
hammer  on  the  head. 

Brow  Ague. — This  is  intermittent  in  its  character,  and  is  brought 
on  by  exposure  to  cold  and  moisture  in  damp  and  marshy  districts ; 
and  in  this  respect  is  much  like  ague. 

Megrims. — This  is  most  frequent  among  females.  It  is  often  de- 
pendent on  the  same  causes  as  Brow  Ague,  and  is  also  produced  by 
long  and  exhausting  watching  over  sick  children,  distress  of  mind, 
and  indigestion. 

In  both  the  above  forms,  the  pain  is  intermittent,  seldom  lasting 
long,  but  being  of  a sharp,  piercing  character  like  that  of  tic  doulou- 
reux. The  pain  of  Megrims  usually  begins  at  the  inner  angle  of  the 
eye,  and  extends  towards  the  nose ; the  parts  being  red  and  sore,  and 
the  eye-ball  tender.  In  Brow  Ague,  pain  and  great  tenderness  cover 
an  entire  half  of  the  head,  compared  by  the  patient,  sometimes,  to 
“ an  opening  and  shutting  of  the  skull.”  It  begins  with  a creeping 
sensation  over  the  scalp. 


232 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


Rheumatic  Headaches. — These  generally  affect  persons  who  have 
been  subject  to  rheumatism,  and  are  often  brought  on  by  uncovering 
the  head  when  sweating.  The  pain  is  usually  in  the  brow,  the  tem- 
ples, or  the  back  of  the  head,  and  is  dull  and  aching,  — rather  an  in- 
tense soreness  than  a real  pain ; and  the  painful  part  is  excessively 
tender  upon  pressure.  The  skin  is  moist,  but  not  hotter  than  natural. 

T reatment. — In  considering  the  treatment,  I will  take  up  the  same 
order  in  which  I have  spoken  of  the  different  forms  of  headache. 

Plethoric  Headaches. — Not  much  medicine  should  be  taken  for 
these,  if  it  can  be  avoided.  A diuretic  (131)  may  be  taken  twice  a 
day,  and  an  occasional  dose  of  gentle  physic  at  night,  followed  by  (7) 
in  the  morning.  This  will  generally  give  great  relief. 

Meat  should  be  taken  but  once  a day,  and  the  whole  diet  should 
be  spare,  the  appetite  never  being  fully  satisfied.  All  spirituous  drinks, 
including  distilled  and  fermented,  should  be  let  alone,  and  coffee  like- 
wise. 

Much  exercise  should  be  taken  in  the  open  air.  The  hair  should 
be  kept  short,  and  the  head  elevated  during  sleep.  Bleeding  at  the 
nose,  when  it  occurs,  must  not  be  too  suddenly  stopped.  Two  drops 
of  the  tincture  of  aconite  root  with  three  of  the  fluid  extract  of  gel- 
semium  repeated  once  a half  hour  for  three  or  four  times  will  be 
found  to  be  of  great  value  in  the  treatment  of  this  form  of  headache. 

The  hot-water  bottle  applied  to  that  part  of  the  spine  between  the 
bead  and  shoulder  blades  will  also  give  great  relief. 

Congestive  Headaches. — The  exercise,  diet,  mode  of  sleeping, 
etc.,  should  be  the  same  as  in  plethoric  headaches.  In  this  complaint, 
there  is  too  much  blood  in  the  head,  and  it  inclines  to  stagnate.  The 
feet  and  hands  are  cold  ; and  gloves  and  stockings  of  wool,  and  other 
bad  conductors  of  heat  from  the  body,  must  be  worn. 

Occasionally  a little  gentle  physic  (319)  is  desirable  to  induce  the 
bowels  to  act  every  day.  If  there  is  great  debility,  iron  (71),  (74), 
(75),  (320),  will  be  required.  The  ice  bag  applied  to  the  last  six  or 
eight  inches  of  the  spine  will  call  the  blood  to  the  extremities.  The 
aconite  and  gelsemium  recipe  as  given  above  is  also  very  useful. 

Headache  of  Indigestion. — If  the  pain  come  immediately  after  a 
meal,  and  can  be  traced  to  something  eaten,  an  emetic  (2)  may  be 
taken,  if  the  person  be  tolerably  strong.  If  the  pain  come  on  some 
hours  after  eating,  take  rhubarb  and  magnesia  (28),  (14),  or  fluid 
magnesia.  When  the  system  is  debilitated,  take  a warm  draught 
(322)  in  the  morning  after  a light  breakfast,  or  twice  a day,  a bitter 
with  an  alkali  (323).  If  the  stomach  be  very  irritable,  bismuth,  at 
meal  times  (324),  (326).  When  it  occurs  after  a debauch,  take  re- 
cipe (325). 

Sick  Headache. — When  it  results  from  food  taken,  a draught  of 
warm  chamomile  tea,  or  a little  weak  bran dy-and- water,  will  generally 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


233 


give  relief.  If  the  sickness  continue,  soda  and  water,  with  a little 
ginger  may  do  well,  or  a mustard  poultice  upon  the  stomach  (165) 
may  be  required.  As  soon  as  it  can  be  kept  on  the  stomach,  a dose 
of  physic  (326)  must  he  taken;  and  if  relief  does  not  come  after  the 
operation  of  this,  give  a bitter  and  an  aromatic  (327).  The  patient 
must  have  perfect  rest.  If  there  he  great  lack  of  tone  in  the  system, 
the  mineral  acids  (328),  (329)  will  be  excellent. 

The  diet  must  be  carefully  regulated,  as  in  plethoric  and  conges- 
tive headaches.  Cocaine,  one-eighth  grain  every  fifteen  minutes  till 
the  nausea  stops,  and  then  a dose  of  physic  is  an  excellent  method  of 
treatment.  Ten  grains  of  amenonol  (ammonol)  every  hour  will 
stop  the  pain,  and  very  often  the  same  amount  of  phenacetine  will 
accomplish  the  same  result. 

Bilious  Headaches. — These  are  generally  connected,  more  or  less, 
with  some  affection  of  the  liver. 

During  an  attack,  if  the  suffering  he  great,  attended  by  nausea, 
give  an  emetic  (2).  In  milder  cases,  give  recipe  (321).  If  there  be 
costiveness,  give  recipe  (.330)  at  night,  and  (7)  in  the  morning. 

A few  doses  of  podophyllin,  leptandrin,  etc.  (34),  (36),  (39),  to  re- 
lieve the  liver  when  the  bile  does  not  flow  fast  enough,  will  diminish 
the  frequency  and  force  of  the  attack.  The  fluid  extract  of  dande- 
lion, taken  for  some  time,  often  does  good  service. 

The  diet  should  be  light,  and  chiefly  vegetable,  and  exercise  in  the 
open  air  must  not  be  omitted.  The  daily  sponge-bath,  with  friction, 
is  excellent, 

Nervous  Headaches. — The  first  thing  to  be  done  is  to  relieve  the 
pain,  and  this  may  generally  be  accomplished  either  by  preparation 
(331),  or  (332),  or  (333),  or  (88),  or  (93),  or  two  or  three  drops  of 
tincture  of  nux  vomica  in  a spoonful  of  water,  taken  three  times  a 
day.  351  will  be  found  usually  to  be  of  most  service. 

In  simple  nervous  headache,  diet  is  of  the  greatest  importance  ; in 
hysterical  cases,  exercise  ; in  headaches  from  exhaustion,  tonics  (81), 
(79),  (63),  (73),  (64),  (61),  (60). 

Of  the  simple  remedies  found  on  the  druggists’  counter  bromide 
of  caffein  in  effervescent  form  is  very  efficacious. 

Rheumatic  Headaches. — Take  a light  diet,  with  but  little  animal 
food.  Wear  warm  clothing,  and  avoid  exposure  to  wet  feet  and  damp- 
ness generally,  and  go  to  a mild  climate,  if  convenient. 

When  the  local  pain  is  great,  apply  hot  fomentations,  or  a stimula- 
ting liniment  (334),  or  a mustard  poultice,  to  the  back  of  the  neck. 
In  the  beginning  of  the  treatment,  a little  physic  at  night  (335)  is 
useful.  10  grs.  potassium  iodide,  gradually  increased,  in  water,  is 
the  best  medicine. 

Before  closing  this  chapter  on  headaches,  let  me  enter  a respectful 
protest  against  the  indiscriminate  use  of  the  thousand  and  one  reme- 
dies advertised  to  cure  headaches ; for  in  a great  majority  of  cases  it 


234 


DISEASES  OF  THE  BEAIN  AND  NERV^ES. 


is  merely  a symptom  of  some  other  disease  ; for  instance,  Indigestion, 
Fever,  Bright’s  Disease,  Softening  of  the  Brain,  Diseased  Liver,  etc. ; 
and  the  use  of  these  remedies  serves  rather  to  increase  than  lessen 
the  difficulty.  Much  has  been  written  and  much  printed  matter 
been  given  away  by  patent  medicine  venders  vaunting  their  specific 
cures  for  headaches.  These  venders  have  grown  in  numbers  of  late, 
since  the  introduction  into  medicine  of  the  coal-tar  products,  so  that 
samples  of  headache  cures  may  be  found  on  one’s  doorsteps  every 
little  while.  For  the  most  part  they  are  composed  of  what  is  known 
as  acetanilide  or  antifebrin,  because  of  its  cheapness  as  compared  with 
other  coal-tar  products.  It  is,  however,  the  most  harmful  of  them 
all,  often  causing  blueness  of  the  lips,  fluttering  of  the  heart,  dizzi- 
ness, faintness,  etc.  Of  other  similar  products  not  so  much  danger 
may  be  expected,  and  yet  no  one  ought  to  resort  to  these  remedies  with- 
out the  consent  and  approval  of  the  family  physician.  Eight  grains 
of  phenacetine  for  an  adult,  repeated  in  two  to  four  hours,  no  doubt 
will  cure  more  headaches  of  all  descriptions  than  any  other  single 
drug.  Lactophenin  and  ammonol  are  some  of  the  newer  remedies  for 
headache  which  have  the  reputation  of  being  efficient  as  coal-tar  prod- 
ucts 'without  any  of  their  ill  effects.  Antikamnia,  a proprietary  medi- 
cine of  the  coal-tar  group,  enjoys  a large  sale,  not  only  for  headaches, 
but  for  general  neuralgic  pain,  and,  if  employed  in  six-grain  doses 
every  two  to  four  hours,  according  to  the  severity  of  the  pain,  will 
stop  a large  proportion  of  these  aches.  The  various  combinations  of 
the  bromides  are  always  safe,  and  often  quite  efficient  in  curing  head- 
aches, especially  if  nerve-element  is  strong  in  their  causation ; bromo- 
caffein,  bromo-seltzer,  bromo-soda,  etc.,  are  generally  put  up  in  small 
bottles  in  an  effervescent  and  palatable  form. 

Locomotor  Ataxia 

Locomotor  ataxia,  also  known  as  tabes,  is  an  affection  of  the 
spinal  cord,  and  although  much  more  is  known  about  the  disease 
to-day  than  ever  before,  yet  since  1847  it  has  had  its  present  name. 

The  particular  portion  of  the  cord  which  controls  the  muscle  sense 
is  diseased,  and  it  is  not  until  very  late  in  the  trouble  that  losses  of 
power  are  apparent.  Men  are  more  often  afflicted  than  women,  and 
most  of  the  cases  occur  between  the  ages  of  thirty  and  forty-five. 

The  venereal  disease  of  syphilis  is  responsible  for  about  three 
fourths  of  all  the  cases,  and  mental  worry  or  shock,  blows  on  the  spine, 
falls,  overwork,  exposure  to  cold  or  storms,  excessive  use  of  stimu- 
lants and  tobacco,  and  sexual  abuses,  are  the  cause  of  the  remainder. 

Symptoms.  — What  are  known  as  the  three  cardinal  or  chief 
symptoms  of  locomotor  ataxia  are  loss  of  the  patella  tendon  reflex, 
the  reaction  of  the  pupil  of  the  eye,  known  as  the  Argyll  Robertson 
pupil,  and  the  swaying  symptom  known  as  the  Romberg  sign. 

The  first  is  the  absence  of  the  usual  sharp  jerk  to  the  leg,  which 
occurs  in  healthy  persons  when  the  tense  tendon  or  cord  just  below 


DISEASES  OP  THE  BRAIN  AND  NERVES. 


235 


the  knee-pan  is  sharply  tapped,  if  the  leg  is  at  a right  angle  to  the 
thigh.  The  second  is  absence  of  reaction  of  the  pupil  to  light.  In 
a healthy  person  the  pupil  dilates  and  contracts  to  both  accommo- 
dation (or  distance)  and  to  light,  while  in  this  disease  it  only  responds 
to  the  first. 

The  swaying  symptom  is  noticed  if  a patient  affected  tries  to  stand 
with  heels  together  and  his  eyes  closed.  While  he  will  be  unaffected 
if  they  are  open,  as  soon  as  he  closes  them  he  sways  violently  and 
many  times  will  fall.  Other  symptoms  are  pains  in  the  calves  of 
the  legs  and  stomach,  which  shoot  with  lightning  rapidity  through 
these  organs.  There  occur  tingling  and  burning  sensations  about 
the  head,  neck,  and  extremities,  shuffling  gait,  due  to  the  loss  of  that 
sense  which  tells  what  position  the  feet  are  placed  in,  and  requiring 
the  eyes  to  be  on  the  ground  to  prevent  the  patient  from  falling 
down.  Disturbances  of  vision  occur,  and  later  a general  weakness 
of  the  body  from  lack  of  sufficient  exercise. 

While  a cure  cannot  be  promised  or  expected,  yet  the  disease  may 
be  arrested  and  controlled  to  a greater  or  less  degree  and  its  extension 
limited  to  slow  progress. 

Treatment.  — Iodide  of  potash  should  always  be  tried  in  every 
case  and  under  a physician’s  direction,  as  the  time  lost  in  experiment- 
ing can  never  be  regained.  Beginning  with  ten  grains  three  times  a 
day,  rapidly  increase  to  the  point  where  the  system  is  saturated,  and 
then  continue  at  this  point  for  some  time.  Mercury,  either  by  the 
mouth  or  rubbed  into  the  skin,  is  a useful  addition. 

For  the  relief  of  pain,  phenacetine  or  some  other  anodyne  prepara- 
tion will  have  to  be  given,  though  morphine  should  be  avoided, 
unless  absolutely  necessary,  owing  to  the  liability,  as  in  any  chronic 
disease,  of  acquiring  a habit. 

Bromide  of  potash  in  doses  of  ten  to  thirty  grains  may  be  given 
to  quiet  the  nerves. 

Proper  exercises,  not  carried  to  the  point  of  fatigue,  massage  of 
the  muscles,  hot  baths  and  electricity,  all  have  their  place  and  prove 
useful. 


NEURASTHENIA.  {Nervous  Prostration.) 

Neurasthenia  is  a condition  of  the  nervous  system  which  by  reason 
of  excessive  fatigue  has  become  so  exhausted  that  the  working 
powers  of  the  body  do  not  act  in  their  natural  manner. 

"What  might  cause  a condition  of  Neurasthenia  in  a nervous  person 
would  not  effect  a slow-going,  phlegmatic  person.  On  the  other  baud 
a condition  severe  enough  to  cause  excitability  and  ungovernable 
irritability  of  temper  in  the  latter  might  be  sufficient  to  cause  in- 
sanity in  the  former  case. 


235a 


DISEASES  OF  THE  BRAIN  AND  NERVES. 


It  is  in  the  high-strung,  nervous  society  woman  or  the  overburdened 
business  man  that  this  trouble  is  prevalent. 

Symptoms.  A person  afflicted  with  Neurasthenia  may  manifest 
it  in  its  simpler  forms  by  excessive  nervousness,  irritabihty  and 
general  crankiness.  In  aggravated  form  by  melancholia,  conditions 
with  gloomy  forebodings,  a desire  to  be  apart  from  friends,  the 
afflicted  has  headaches,  is  unable  to  sleep,  has  dizzy  attacks  or  ver- 
tigo, loss  of  memory.  Cannot  concentrate  attention  for  any  length 
of  time,  and  later  on  muscular  and  other  weaknesses  are  noticeable. 

Treatment.  Complete  rest,  sui  able  food,  proper  stimulation  and 
surroundings  of  improved  hygienic  and  moral  conditions.  Massage, 
baths  of  different  varieties,  travel,  light  reading,  release  from  trying 
cares,  fresh  air  and  change  of  occupation  are  necessary  to  effect  a 
cure. 


% 


¥ 


DISEASES  of  the  THROAT 


DISEASES  OF  THE  THROAT. 

(Also  see  Anatomy  of  Throat  and  Anatomy  of  Vocal  Organs.) 


The  diseases  which  seat  themselves  in  the  throat,  and  in  the  great 
cavity  of  the  chest,  have  occupied  a large  share  of  my  attention  for 
the  last  ten  years.  My  practice  in  these  complaints  has  been  large, 
— being  drawn  from  every  part  of  the  United  States,  and  the  British 
Provinces.  No  class  of  diseases  from  which  men  suffer  are  more  nu- 
merous than  these,  and  none  have  so  generally  baffled  the  skill  of  the 
profession.  For  this  reason,  I wish  to  present  here  a brief,  practical, 
and  common-sense  view  of  these  complaints,  which  shall  be  of  real 
value  to  the  thousands  of  families  who  consult  these  pages. 

Increase  of  Throat  Diseases. — A striking  increase  in  the  number 
of  throat  diseases  has  been  witnessed  within  the  last  few  years.  A 
person  suffering  from  any  of  them  will  find,  on  speaking  of  his  com- 
plaint, that  a number  of  his  neighbors  are  afflicted  with  troubles  of  a 
similar  kind.  I have  thought  that  in  some  of  their  forms  these  dis- 
eases have  fastened  upon  the  throats  of  not  less  than  half  our  popu- 
lation. And  when  it  is  considered  that  they  are  the  natural,  and  if 
unmolested,  the  certain  harbingers  of  lung  disease,  it  is  wise  to  make 
a note  of  the  above  fact.  As  I shall  describe  them  in  the  nasal  cavi- 
ties, the  pharynx,  the  fauces,  etc.,  they  all  have  a natural  proclivity 
downwards.  From  these  upper  cavities  they  pass,  by  one  short  step, 
into  the  larynx, — the  cavity  where  the  voice  is  formed,  — and  then, 
by  another  equally  short  and  easy  stage,  into  the  body  of  the  wind- 
pipe. It  is  a singular  fact  that  their  progress  is  always  from  the 
upper  breathing  passages  downward,  and  never  from  the  lower  pas- 
sages upward.  They  afford  a parallel  to  the  order  of  progression  in 
the  moral  world,  in  which  evil  tendencies  are  toward  a lower  depth. 

A Mistake  Corrected.  — Before  describinsf  the  several  diseases 
which  belong  to  this  family,  I wish  to  correct  the  mistake  which  so 
generally  classes  them  all  under  the  term  Bronchitis. 

They  all  consist  in  a simple  inflammation,  acute  or  chronic,  either 
of  the  mucous  membrane  lining  the  several  cavities  to  be  spoken  of, 
or  of  the  small  glands  or  follicles  connected  with  that  membrane ; 
and  each  disease  takes  its  name  from  its  particular  location.  Thus, 
the  inflammation  of  the  membrane  lining  the  upper  part  of  the  throat, 
or  pharynx,  is  called  Pharyngitis.  Inflammation  in  the  top  of  the 


DISEASES  OF  THE  THROAT. 


237 


windpipe,  or  larynx,  is  Laryngitis.  In  the  windpipe,  or  trachea,  it  is 
Trachitis.  In  the  bronchial  tubes,  it  is  Bronchitis.  As  the  bronchial 
tubes  exist  nowhere  except  in  the  lungs,  below  the  division  of  the 
windpipe,  there  can  be  no  Bronchitis  in  the  throat.  Nevertheless,  it 
is  the  same  disease  with  Laryngitis  and  Pharyngitis,  and  differs  from 
them  only  in  being  in  a more  dangerous  place. 

As  the  windpipe  descends  into  the  chest,  it  divides  below  the  top 
of  the  breast-bone  into  two  branches,  one  going  into  the  right,  the 
other  into  the  left  lung.  These  branches  divide  and  subdivide  very 
minutely,  and  send  their  ramifications  into  every  part  of  the  pulmon- 
ary tissue.  Thus  situated,  Meckel  has  compared  the  windpipe  to  a 


FlQ.  86. 

hollow  tree  with  the  top  turned  downward, — the  larynx  and  trachea 
representing  the  trunk,  and  the  bronchial  tubes,  with  their  innumera- 
ble subdivisions,  the  branches  and  twigs.  (Fig.  86.) 

If  the  reader  will  now  understand  that  the  trunk  and  branches  of 
this  bronchial  tree  are  hollow  throughout,  and  lined  with  a delicate 
and  smooth  mucous  membrane,  and  that  the  diseases  to  be  described 
are  inflammation  either  upon  this  membrane  or  the  small  glands  con- 
nected with  it,  causing  swelling,  redness,  unhealthy  discharges,  rough 
ness,  etc.,  he  will  have  a good  general  idea  of  them. 

Nasal  Catarrh. 

I TAKE  these  diseases  in  the  order  of  their  location.  Nasal  Catarrh 
consists  in  inflammation,  which  begins  behind  and  a little  above  the 


238 


DISEASES  OF  THE  THROAT. 


veil  of  the  palate,  and  extends  upward  from  thence  into  the  nose.  It 
is  an  exceedingly  troublesome  complaint,  and  afflicts  great  numbers. 
It  passes  under  the  name  of  Catarrh  in  the  Head. 

The  inflammation  is  not  confined  to  the  nasal  cavities.  It  extends 
frequently  to  the  air-cavities,  called  antrums  and  simise.%  which  cover 
a considerable  portion  of  the  face,  and  extend  to  the  lower  part  of  the 
forehead.  Persons  sometimes  feel  as  if  their  whole  face  were  in- 
volved in  the  disease,  and  were  almost  in  a state  of  rottenness,  — so 
great  is  the  amount  of  matter  discharged  from  the  head.  Such  free 
discharges  cannot  be  wondered  at  when  we  reflect  that  all  the  air 
cavities  in  the  face  are  lined  with  the  same  mucous  membrane  which 
lines  the  nose,  and  that  they  all  communicate  with  the  nasal  cavities. 

The  “ horn  ail,”  among  cattle,  is  a similar  inflammation  of  the  inner 
surface  of  the  horns  ; and  the  “ horse  distemper  ” is  an  inflammation  of 
the  air  cavities  in  the  head  of  the  horse,  and  is  much  the  same  disease 
with  our  catarrh  in  the  head. 

The  catarrh  often  creates  a perpetual  desire  to  sivallow^  and  gives 
the  feeling,  as  patients  express  it,  “ as  if  something  were  sticking  in  the 
upper  part  of  the  throat.'"’ 

When  the  inflammation  has  existed  a long  time,  and  ulceration 
has  taken  place,  puriform  matter  is  secreted,  and  drops  down  into  the 
throat,  much  to  the  discomfort  of  the  patient.  Indeed,  this  is  one  of 
the  most  distressing  features  of  the  complaint,  as  this  matter  often 
descends  into  the  stomach  in  large  quantities,  causing  frequent  vom- 
iting, and  a general  derangement  of  the  health.  Many  times  the  suf- 
ferer can  only  breathe  with  the  mouth  open.  Upon  rising  in  the 
morning  a great  effort  is  required  to  clear  the  head  and  the  extreme 
upper  part  of  the  throat.  There  is  occasionally  a feeling  of  pressure 
and  tightness  across  the  upper  part  of  the  nose ; and  the  base  of  the 
brain  sometimes  suffers  in  such  a way  as  to  induce  headache,  vertigo, 
and  confusion.  The  smell  is  frequently  destroyed,  and  sometimes 
the  taste.  The  inflammation  sometimes  gets  into  the  Eustachian 
tubes,  the  mouths  of  which  are  behind  and  a little  above  the  veil  of 
the  palate,  and  extends  up  the  lining  membrane  to  the  drum  of  the 
ear,  causing  pain  or  deafness,  and  occasionally  both.  In  addition  to 
this  catalogue  of  evils,  there  is  often  added  inflammation  and  elon- 
gation of  the  uvula  or  soft  palate. 

Treatment. — The  following  is  a fair  illustration  of  my  mode  of 
treatment : — 

Mr. , of  Boston,  came  under  treatment  for  a bad  case  of  ca- 

tarrh in  the  head,  complicated  with  follicular  disease  of  the  pharynx, 
or  upper  part  of  the  throat.  In  addition  to  nearly  all  the  symptoms 
mentioned  above,  he  had  a stench  from  the  nose  exceedingly  offen- 
sive to  all  about  him.  So  much  had  the  disease  worn  upon  him  that 
he  had  become  bilious,  sallow,  dejected,  and  low  in  strength  and  flesh. 

When  it  is  said  that  to  all  these  were  added  a cough  and  loss  of  ap- 
petite, with  insidious  approaches  of  hectic,  it  will  not  be  surprising 


DISEASES  OF  THE  THROAT, 


239 


that  his  friends  saw  the  most  serious  results  impending,  even  though 
assured  by  me  that  the  disease  had  not  yet  taken  a firm  hold  of  his 
lungs.  The  first  thing  done  for  him  was  to  cut  off  the  uvula.  Five 
days  after,  I began  to  bathe  the  whole  nasal  cavity,  three  times  a 
week,  with  a shower  syringe,  by  pushing  the  smooth  bulb  up  behind 
the  veil  of  the  palate,  and  throwing  instantaneously  a most  delicate 
shower  of  medicated  fluid  up  both  sides  of  the  septum.'  The  upper 
part  of  the  throat  was  likewise  bathed  by  the  use  of  a shower  syringe 
made  expressly  for  that  part,  and  the  larynx,  or  place  where  the  voice 
is  formed,  by  a long,  bent  instrument  made  to  reach  this  part  of  the 
throat.  The  solution  used  consisted  of  half  a dram  of  crystals  of  ni- 
trate of  silver  dissolved  in  one  ounce  of  soft  water. 

The  nitrate  of  silver  powder  was  inhaled  once  a day  with  the  pow- 
der inhaler.  In  this  way  the  nasal  cavities  and  throat  were  kept 
cleansed,  and  the  articles  used  gradually  subdued  the  inflammation, 
setting  up  a new  and  healthful  action  in  place  of  the  diseased  one. 
The  stomach  was  relieved  of  the  offensive  matter  which  had  daily 
and  nightly  gone  down  into  it,  and  the  system  of  the  poisonous  ef- 
fects of  its  absorption.  The  great  danger  which  threatened  the  lungs, 
and  which  would  soon  have  been  realized  in  their  destruction,  passed 
away.  The  skin  gradually  resumed  its  proper  color;  the  appetite, 
flesh,  spirits,  and  strength  came  back,  and  Mr,  B.  has  been  since  in 
the  enjoyment  of  good  health,  pursuing  his  business  cheerfully. 

When  the  above  treatment  fails,  as  it  does  occasionally,  I am  in 
the  habit  of  changing  the  solution,  using  sometimes  a weak  solution 
of  acid  nitrate  of  mercury,  twenty  drops  to  an  ounce  of  water.  In 
other  cases,  a solution  of  sulphate  of  zinc  serves  a good  purpose.  A 
dilution  of  the  tincture  of  arnica-flowers  is  a preparation  of  some 
value  in  these  cases.  There  are  other  preparations,  too  numerous  to 
mention,  which  I am  in  the  habit  of  using.  I will  add,  that  the 
nitrate  of  silver  powder,  snuffed  once  a day,  a pinch  at  a time,  is  far 
more  successful  than  any  other  muff  ever  made,  but  should  be  used 
only  in  severe  cases,  and  with  caution. 

Nasal  catarrh  is  such  a common  affliction  in  the  Eastern  States,  as 
to  be  a widespread  curse.  Douching  the  nose  with  salt  and  water 
(warmed)  cleanses  the  nose  of  the  foul  mucus.  The  douche  should 
be  from  a bag  hanging  only  a little  higher  than  the  head,  or  it  may  be 
given  by  means  of  a common,  blunt-pointed  syringe,  care  being  taken 
not  to  use  too  strong  force,  nor  to  point  the  syringe  in  the  direction 
of  the  eyes.  The  stream  of  water  should  be  directed  straight  ahead 
parallel  with  the  floor ; the  mouth  must  be  open,  and  the  patient  as- 
sume the  position  of  the  countryman  when  gazing  or  gauking  at  the 
sights  on  his  first  visit  to  the  city.  The  water  then  runs  down  the 
throat  and  also  out  of  the  other  nostril.  This  process  should  be  em- 
ployed on  both  sides  till  the  head  is  clean.  The  tablets  put  up  by  all 
wholesale  druggists,  called  “Carl  Seiler’s  alkaline  tablets,”  is  the  best 
remedy  for  a nasal  douche.*  The  subsequent  treatment  is  best  ad- 

* One  of  these  tablets  dissolved  in  a half  cup  of  water.  Practically  the  same  solution  may  be 
^ade  by  adding  to  the  same  amoimt  of  hot  water  10  grains  of  borax,  15  grains  of  cooking  soda 
and  5 grains  benzoate  of  soda. 


240 


DISEASES  OF  THE  THROAT. 


vised  by  a physician,  and  usually  consists  in  the  use  of  some  inhala- 
tion or  spray. 

Inflammation  of  the  Pharynx.  — Pharyngitis. 

This  is  an  inflammation  of  the  upper  and  back  part  of  the  throat, 
or  all  that  part  which  can  be  seen  when  the  mouth  is  stretched  open. 
It  causes  a redness  of  the  mucous  membrane  lining  the  part,  which 
is  deep  in  proportion  to  the  intensity  of  the  inflammation.  This 
complaint  is  generally  connected  with  the  one  I am  about  to  describe ; 
and  since  the  treatment  is  the  same  the  reader  is  referred  to  what 
next  follows. 

Adenoid  Growths. 

In  young  children  a very  disagreeable  catarrhal  affection  often  ex- 
ists in  the  naso-pharynx  just  behind  and  above  the  uvula.  This  is 
caused  by  continued  catarrh  till  at  last  small  growths  occur  like 
proud-flesh,  and  not  infrequently  block  up  the  passage  from  the  nose 
to  the  mouth,  to  that  extent  that  not  only  is  loud  snoring  produced  at 
night,  but  breathing  becomes  difficult  by  day.  In  severe  cases  the  up- 
per jaw  becomes  angular,  and  the  face  assumes  a peaked,  pinched  look. 
These  growths  are  extremely  eommon  in  children,  and  are  produc- 
tive of  much  mischief.  The  inability,  in  severe  cases,  to  properly 
breathe  deprives  the  lungs  of  their  proper  amount  of  oxygen,  so  that 
the  little  one  suffers  in  nutrition  and  growth. 

Treatment  consists  in  scraping  away  with  a scoop,  or  even  with 
the  finger,  these  soft,  granulating  masses.  The  effect  is  almost  mar- 
vellous : the  child  breathes  quietly,  without  snoring,  the  color  re- 
turns to  the  cheeks,  and  the  blood  receives  a new  supply  of  food  from 
the  full  supply  of  oxygen.  In  modern  times,  nothing  has  been  in- 
augurated in  the  treatment  of  children’s  throat  and  nose  diseases  so 
beneficial  and  happy. 

Clergymen’s  Sore  Throat.  — Follicular  Pharyngitis. 

This  disorder  made  its  appearance  in  this  country  in  1830,  and  the 
attention  of  the  profession  was  first  drawn  to  it,  as  a distinct  disease, 
in  1832.  Some  have  supposed  its  origin  to  have  had  a hidden  con 
nection  with  the  epidemic  influenza  which  spread  over  the  civilized 
world  in  1830,  and  affected  all  classes  of  persons ; but  this  is  only 
conjecture.  In  its  early  developments  it  attracted  notice  chiefly  by 
its  visitations  upon  the  throats  of  the  clergy.  Hence  its  popular 
name  of  Clergymen' s Sore  Throat.  It  was  soon  found,  however,  to  at- 
tack all  classes  of  persons  indiscriminately,  whether  engaged  in  any 
calling  which  required  a public  exercise  of  the  voice  or  otherwise.  It 
was  noticed  more  by  public  speakers  and  singers,  on  account  of  the 
greater  inconvenience  it  gave  them. 

The  disease  consists  in  a chronic  inflammation  of  the  mucous  fol- 

r 


DISEASES  OF  THE  THROAT. 


241 


licles,  or  glands,  connected  with  the  mucous  membrane  which  lines 
the  throat  and  windpipe.  The  office  of  these  little  glands  is  to  secrete 
a fluid  to  lubricate  the  air  passages.  When  inflamed,  they  spread  an 
acrid,  irritating  fluid  over  surrounding  parts,  which  excites  inflamma- 
tion in  them.  Hence  a general  inflammation  of  the  upper  part  of  the 
throat  or  pharyngitis  usually  attends  the  follicular  disease,  and  I 
shall  speak  of  the  two  together.  This  inflammation  of  the  glands 
and  the  membrane,  being  neglected,  as  it  generally  is,  lingers  on  from 
month  to  month,  or  from  year  to  year,  making  in  some  cases  slow 
progress,  in  others  more  rapid,  — made  a little  worse  and  its  step 
slightly  quickened  by  every  fresh  cold,  and  finally  results  in  ulcera- 
tion. The  expectoration  thenceforward  becomes  puriform,  and  finally 
undistinguishable  from  that  of  consumption,  with  all  the  symptoms 
of  which  the  patient  finally  dies.  Indeed,  before  its  nature  was  un- 
derstood by  the  profession,  it  was  considered  the  most  fatal  form  of 
consumption,  because  it  could  be  affected  only  in  a very  small  de- 
gree, if  at  all,  by  medicines  taken  into  the  general  system.  For  the 
milder  cases  one  will  find  great  comfort  in  the  use  of  the  troches  of 
cubebs  and  ammonia,  the  inhalation  of  benzoin  with  steaming  water, 
also  from  such  throat-tablets  as  the  Chloramine. 


Inflammation  of  Mucous  Membrane  and  Glands 
of  Larynx.  — Follicular  Laryngitis. 

A FEW  strong  and  beautifully  formed  cartilages  unite  to  form  a 
curious  and  convenient  box  or  cavity  at  the  top  of  the  windpipe, 
called  the  larynx.  Across  this  enclosure  are  stretched  two  remark- 
able ligaments,  called  the  vocal  cords.  They  are  from  half  to  three 
quarters  of  an  inch  in  length,  and  are  rendered  more  or  less  tense  by 
the  small  muscles  with  which  they  are  connected.  Just  above  these 
cords  are  two  cavities,  which,  with  the  ligaments,  act  an  important 
part  in  the  formation  of  the  voice.  Here  is  produced  the  sound, 
which  is  modified  and  articulated  by  the  tongue,  the  lips,  and  the 
nasal  cavities. 

When  disease  reaches  this  cavity,  and  the  fluid  secreted  to  lubri- 
cate these  cords  becomes  acrid,  the  voice,  from  this  and  other  causes, 
is  made  hoarse ; and  when,  at  length,  these  ligaments  are  altered  in 
structure  by  inflammation  and  ulceration,  the  voice  suffers  a gradual 
extinction.  I have  treated  a large  number  suffering  entire  loss  of 
voice,  and  am  happy  to  say  it  has  been  generally  restored,  where  the 
lungs  have  not  been  involved  in  the  disease.  There  is  often  also  a 
little  sensitiveness,  or  even  soreness,  in  some  cases,  in  the  region  of 
the  larynx,  which  may  be  felt  by  pressing  upon  that  prominence  in 
front  of  the  throat,  called  Adam’s  apple.  . 


242 


DISEASES  OF  THE  THEOAT. 


Inflammation  in  the  Windpipe. — Tracheitis. 

This  complaint  and  the  one  preceding  it  differ  only  in  their  local- 
ity from  those  described  in  the  upper  cavities ; and  they  are  more 
alarming,  because  two  removes  nearer  the  citadel  of  hfe.  Happily, 
we  know  that  the  seat  of  these  diseases  may  be  easily  reached,  and 
we  have  a shower  syringe,  so  arranged  as  to  pour  the  remedial  agent 
directly  upon  them,  without  any  lacerating  disturbance  of  the  parts. 

Symptoms. — The  approach  of  these  disorders  is  often  so  insidious 
as  hardly  to  attract  notice, — sometimes  for  months  or  even  years, — 
giving  no  other  evidence  of  their  presence  than  the  annoyance  of 
something  in  the  throat  to  be  swallowed  or  hawked  up,  an  increased 
secretion  of  mucus,  and  a sense  of  wearisomeness  and  loss  of  power 
in  the  throat  after  public  speaking,  singing,  or  reading  aloud.  At 
length,  upon  the  taking  of  a severe  cold,  the  prevalence  of  an  epi- 
demic influenza,  or  of  an  unexplained  tendency  of  disease  to  the  air- 
passages  and  lungs,  the  throat  of  the  patient  suddenly  becomes  sore, 
its  secretions  are  increased  and  rendered  more  viscid,  the  voice  grows 
hoarse,  the  difficulty  of  speaking  is  aggravated,  and  what  was  only 
an  annoyance  becomes  an  affliction  and  a source  of  alarm  and  dan- 
ger. These  diseases  clearly  belong  to  the  family  of  consumption,  and 
need  early  attention. 

Causes. — It  is  amusing  to  reflect  upon  the  theories  which  writers 
were  in  the  habit  of  constructing,  a few  years  since,  to  account  for 
the  throat  affection  among  the  clergy.  It  was  attributed  by  some 
to  speaking  too  often,  by  others  to  speaking  too  loud.  One  class  of 
writers  thought  it  arose  from  muffling  the  neck ; another,  from  a 
strain  of  voice  on  the  Sabbath  to  which  it  was  not  accustomed  on 
other  days. 

The  cause  lies  deeper  than  any  of  these  trifling  things.  As  it  con- 
cerns ministers,  it  may  generally  be  expressed  in  two  words, — labor, 
anxiety. 

The  clerical  order  are  placed  just  where  they  feel  the  force  of  the 
high-pressure  movements  of  the  age.  They  are  the  only  class  of 
recognized  instructors  of  adult  men,  and  are  obliged  to  make  great 
exertions  to  meet  the  wants  of  their  position.  The  extremely  tiyiag 
circumstances  in  which  they  are  often  placed,  too,  in  these  exciting 
times,  by  questions  which  arise  and  threaten  to  rupture  and  destroy 
their  parishes,  weigh  heavily  upon  their  spirits,  and  greatly  depress 
the  vital  powers.  And,  when  we  add  to  this  the  fickle  state  of  the 
public  mind,  and  often  the  shifting,  fugitive  character  of  a clergy 
man’s  dwelling-place  and  the  consequent  liability  to  poverty  and  want 
to  which  himself  and  family  are  exposed,  we  have  a list  of  depressing 
causes  powerfully  predisposing  to  any  form  of  disease  which  may 
prevail. 


DISEASES  OF  THE  THEOAT. 


243 


It  will  be  pardoned  me,  I think,  if  I suggest  here,  that  the  nature 
of  a clergyman’s  calling  is  of  so  serious  a character,  that  he  some- 
times carries  himself  with  too  much  sedateness,  keeps  himself  too 
much  braced  up,  and  does  not  allow  himself  hours  enough  of  that 
cheerful,  light-hearted  abandon,  which  is  essential  to  the  health  of 
every  sedentary  man  of  mental  habits.  The  hard-thinking  and  hard- 
working minister,  who  will  retain  his  health  and  save  his  throat,  must 
have  some  moments,  at  least,  when  the  weighty  responsibilities  of  his 
office  are  lifted  up  from  his  soul,  and  he  becomes,  for  the  hour,  the 
jocund,  playful  boy  of  earlier  days.  How  far  he  can  consistently  re- 
lax and  let  himself  down,  or  in  my  view  of  the  matter,  raise  himself 
up  to  the  simplicity  and  mirth  of  childhood,  he  alone  can  be  the  judge. 
As  a physician,  I prescribe ; as  a minister,  he  must  decide  how  far 
my  prescription  can  be  followed. 

Reading  Sermons. — There  is  one  practice,  which,  though  it  has 
not  much  to  do  with  inducing  this  disease,  does  frequently  aggravate 
it  when  once  established  ; I mean  the  habit  of  reading  sermons  from 
manuscripts,  — especially  when  it  is  done  in  a sort  of  mechanical 
way.  Every  person  who  has  suffered  from  throat-ail  has  doubtless 
noticed  that  to  read  aloud,  for  half  an  hour,  from  a book,  occasions 
more  fatigue  and  irritation  in  the  throat  than  extemporaneous  speak- 
ing, in  the  same  tones,  for  one  or  two  hours.  The  reason  is,  that  in 
the  latter  case  the  mind  conceives  the  thought  in  season  for  the  or- 
gans of  speech  to  fall  into  a natural  attitude,  and  utter  it  with  ease. 
The  two  work  harmoniously  together, — the  instruments  of  articula- 
tion following  the  mind,  and  easily  and  naturally  uttering  its  concep- 
tions. Whereas  in  the  case  of  reading,  the  mind  itself  is,  at  least 
partially,  ignorant  of  what  is  coming  until  it  is  just  upon  it,  so  that 
the  organs  of  speech,  being  warned  of  what  is  to  be  done  only  at  the 
moment  their  service  is  required,  do  their  work  under  a perpetual 
surprise  and  constraint.  The  difference  is,  in  some  respects,  like  that 
between  walking  freely  at  large,  without  regard  to  where  the  feet  are 
put  down,  and  being  obliged  to  step  exactly  in  the  footprints  of  some 
traveller  who  has  gone  before.  In  the  latter  case,  the  muscles  tire 
much  sooner,  because  they  work  in  fetters. 

I have  thus  spoken  particularly  of  the  clergy,  though  it  is  not  by 
any  means  they  only,  but  all  classes  of  people  who  are  afflicted  with 
this  dangerous  malady. 

These  diseases  often  legin  with  a cold.  But  colds  are  seldom  taken 
except  when  the  nervous  system  is  depressed,  so  that  they  are,  in  fact, 
to  he  traced  back  to  the  same  cause  which  I have  assigned  to  catar- 
rhal or  throat  complaints  themselves. 

These  Complaints  Worse  at  Night. — It  is  worthy  of  note,  that  all 
these  complaints,  and  many  others,  are  worse  during  the  night.  This 
is  easily  explained  when  we  remember  that  the  atmosphere  has  the 
least  amount  of  electricity  in  it  at  three  o’clock  in  the  morning,  and 
that  the  first  minimum  atmospheric  pressure,  which  happens  twice  a 


244 


DISEASES  OF  THE  THROAT. 


day,  occurs  not  far  from  the  same  hour.  From  three  to  four  in  the 
morning,  therefore,  the  nerve-power  sinks  to  its  lowest  ebb ; and  those 
diseases  which  owe  their  existence  to  anxiety,  overwork,  etc.,  suffer, 
at  this  time,  their  greatest  daily  aggravation.  Death  occurs,  too,  more 
often  during  these  hours,  than  in  any  other  portion  of  the  twenty- 
four. 

Treatment. — Some  years  ago  these  diseases  were  thought  to  be 
incurable ; and  by  all  the  appliances  of  medical  art  then  known,  they 
were  so.  But  time  has  brought  a successful  method  of  treatment,  as 
well  as  a clearer  knowledge  of  their  nature. 

This  treatment  consists  in  what  is  called  topical  medication,  or  the 
applying  of  the  medicine  directly  to  the  diseased  part.  The  medici- 
nal agent  more  extensively  used  than  any  other  is  a solution  of  crys- 
tals of  nitrate  of  silver.  This  substance  is  not,  however,  adapted  to 
every  case, — other  articles  succeeding  better  in  some  instances.  Mod- 
ern chemistry  has  given  us  a variety  of  agents  from  which  the  skilful 
physician  may  select  a substitute,  should  the  nitrate  of  silver  fail. 

The  operation  of  applying  this  and  other  substances  to  the  air  pas- 
sages, is  a delicate  one,  requiring  tact  and  experience.  Surgeons  had 
supposed  it  an  anatomical  impossibility  to  introduce  an  instrument 
into  the  larynx  ; but  this  has  been  practically  demonstrated  to  be  a 
great  mistake. 

Instruments. — The  instrument  devised  and  used  by  Dr.  Horace 
Green  is  a piece  of  whalebone,  bent  at  one  end,  to  which  is  attached 
a small,  round  piece  of  sponge.  This,  dipped  in  the  solution,  is  dex- 
terously introduced  into  the  laryngeal  cavity,  and  applied  directly  to 
the  diseased  part. 

I formerly  used  this  instrument  myself,  and  am  happy  to  know, 
that,  notwithstanding  its  defects,  it  was  generally  successful.  Yet 
where  the  larynx  was  highly  inflamed,  with  a swollen  and  ulcerated 
condition  of  the  epiglottis  and  lips  of  the  glottis,  I am  sure  I some- 
times had  the  singular  powers  of  the  nitrate  of  silver  put  at  defiance 
by  an  irritation  evidently  produced  by  the  sponge  of  the  probang. 
Upon  its  introduction,  in  such  cases,  the  parts  contract  upon  and 
cling  to  it,  and  suffer  aggravated  irritation,  almost  laceration,  upon 
its  withdrawal,  however  carefully  effected. 

Laryngeal  Shower  Syringe. — Such  defects  in  the  probang  led  me 
to  contrive  an  instrument,  which  I call  a Laryngeal  Shower  Syringe. 
It  is  in  the  form  of  a syringe,  the  barrel  and  piston  of  which  are 
made  of  glass,  silver,  or  gold,  as  may  be  desired.  To  this  is  attached 
a small  tube,  made  of  silver  or  gold,  long  enough  to  reach  and  enter 
the  throat,  and  bent  like  a probang,  with  a globe  or  bulb  at  the  end, 
from  a quarter  to  a third  of  an  inch  in  diameter,  pierced  with  very 
minute  holes,  which  cover  a zone  around  the  centre  about  one-third 
of  an  inch  in  breadth. 

This  silver  bulb  I daily  introduce  into  highly  inflamed  and  ulcer- 


i 


DISEASES  OF  THE  THROAT.  245 

ated  larynges,  generally  without  any  knowledge  of  its  presence  on 
the  part  of  the  patient,  until  the  contained  solution  is  discharged. 
The  instrument,  being  charged,  is  carried  to  the  proper  place,  when  a 
delicately  quick  pressure  upon  the  piston  causes  very  fine  streams  to 
fiow  through  the  holes  in  the  form  of  a delicate  shower,  and  all  sides 
of  the  walls  of  the  larynx  are  instantaneously  bathed. 

How  Introduced. — The  introduction  of  this  instrument  into  the 
larynx  is  easy.  Upon  the  approach  of  any  foreign  substance,  the  epi- 
glottis instinctively  drops  down  upon  the  entrance  to  the  larynx, 
guarding  it  against  improper  intrusions.  It  has  been  found,  however, 
that  when  the  root  of  the  tongue  is  firmly  depressed,  this  cartilage 
cannot  obey  its  instinct,  but  stands  erect,  its  upper  edge  generally  ris- 
ing into  view.  Availing  himself  of  this,  the  surgeon  has  only  to  de- 
press the  tongue  with  a spatula,  bent  at  right  angles,  so  that  the  left 
hand  holding  it  may  drop  below  the  chin  out  of  the  way,  and  as  the 
epiglottis  rises  to  view,  slip  the  ball  of  the  instrument  over  its  upper 
edge,  and  then  with  a quick  yet  gentle  motion,  carry  it  downward  and 
forward,  and  the  entrance  is  made.  I have  often  admired  the  faith- 
fulness of  this  epiglottic  sentinel,  who,  when  overborne  by  superior 
force,  stands  bolt  upright,  and  compels  us  to  enter  the  sacred  temple  of 
speech  directly  over  his  head  ! 

Pharyngeal  Shower  Syringe. — For  washing  the  upper  part  of  the 
throat,  I construct  the  instrument  with  a straight  tube,  with  holes 
over  the  outer  end  of  the  globe,  and  extending  to  the  centre.  This 
washes  instantaneously  the  fauces  and  pharynx,  but  does  not  throw 
the  solution  back  upon  the  tongue.  Its  main  advantage  over  the 
probang  is,  that  it  bathes  every  part  of  the  fauces  and  pharynx  in- 
stantaneously, and  does  not  subject  the  patient  to  tire  coughing  and 
gagging  which  follow  the  slower  and  rougher  process  of  drawing  the 
sponge  from  side  to  side  across  the  cavity  of  the  throat. 

Nasal  Shower  Syringe. — Inflammations  in  the  back  passages  to 
the  nose,  called  catarrh  in  the  head,  have  been  almost  inaccessible  by 
any  reliable  healing  agent,  and  consequently  incurable.  The  probang 
could  only  reach  a short  distance,  and  occasioned  great  suffering.  I 
have  had  a syringe  constructed  with  the  tube  bent  at  an  angle  of 
forty-five  degrees,  and  the  globe,  very  small,  pierced  with  a few  fine 
holes  at  the  upper  end.  Carrying  this  globe  up  behind  the  velum 
palati,  with  a single  injection  I wash  both  passages  clear  throu  gh.  I 
have  had  the  pleasure  of  curing  a large  number  of  bad  cases,  of  many 
years’  standing,  to  the  surprise  and  delight  of  the  patients. 

About  nineteen-twentieths  of  the  physicians  who  have  examined 
these  instruments,  and  so  far  as  my  knowledge  extends,  all  who  have 
used  them,  think  them  much  better  than  the  probang.  As  to  patients, 
I have  yet  to  see  one  who  will  allow  the  sponge  to  be  used  after  try- 
ing both. 

Have  Superseded  the  Probang. — In  my  own  practice  the  syringes 


246 


DISEASES  OE  THE  THROAT. 


have  superseded  the  probang  altogether.  My  reasons  may  be  briefly 
stated.  I have  already  said  there  is  less  irritation  produced.  A piece 
of  sponge  drawn  over  an  inflamed  surface,  especially  when  elung  to 
by  the  irritated  and  quivering  parts,  must  neeessarily,  in  some  cases 
at  least,  aggravate  the  symptoms  of  disease.  To  this  eonsideration 
add  the  comfort  of  the  patient  during  the  operation.  It  is  so  quickly 
and  delicately  done  with  the  syringe,  that  it  is  scarcely  known  when 
the  act  is  performed.  The  straight  syringe  does  not  touch  the  throat 
at  all.  On  toucliing  the  probang  to  the  throat,  the  nitrate  of  silver 
unites  with  the  mucus  upon  the  surface,  instantly  covering  the  sponge 
with  an  albuminous  pellicle,  something  like  that  which  lines  the  shell 
of  an  egg,  preventing,  in  a degree,  the  further  pressing  out  of  the 
solution,  and  rendering  its  contacts  with  other  parts  of  the  surface 
comparatively  powerless.  For  this  reason,  the  sponge  pushed  down 
into  an  uleerated  bronchus,  as  Dr.  Green  recommended,  must  be  ut- 
terly valueless  as  a remedial  agent.  Mopping,  as  it  does  in  its  whole 
course,  a larynx  and  trachea,  lined  in  some  cases  with  puriform  mat- 
ter, and  generally  with  mucus,  every  inch  of  its  descent  doubles  the 
gravity  of  this  objection.  Let  it  be  considered,  too,  that  in  applying 
the  remedy  to  an  ulcerated  larynx,  the  sponge  cauterizes  the  healthy 
parts  above,  in  its  descent,  and  thus  unfits  itself  for  doing  much  for 
the  diseased  part ; whereas  the  syringe  retains  its  solution  till  it 
reaches  the  affected  place,  and  then  pours  a clean  shower  directly 
u^ion  it,  and  upon  no  other  part. 

Considering  these  manifest  advantages  of  the  syringes,  I am  sur- 
prised that  any  physician  should  still  use  the  probang, — especially  as 
one  of  these  instruments,  the  Nasal  Syringe,  accomplishes  an  object 
which  the  probang  cannot  effect  at  all,  not  even  in  a rough  way.  I 
have  wondered,  too,  how  any  parent  can  allow  a clnld,  suffering  with 
croup,  to  be  tormented  by  having  a sponge  pushed  down  its  throat, 
when  a syringe  would  give  it  so  much  less  pain. 

I will  mention  briefly  one  or  two  cases  of  croup  and  diphtheria,  se- 
lected from  a great  number  treated  by  me  for  the  last  few  years,  where 
the  syringes  were  successfully  used,  after  several  attempts  to  use  the 
probang  had  been  made,  and  failed,  and  where  the  pain  caused  by 
using  was  so  small,  and  the  relief  so  instantaneous  and  complete,  that 
the  patients  were  anxious  for  my  return  to  use  it  again. 

I was  called  to  see  a little  boy  of  Mr.  R.,  five  years  old,  who  had 
had  an  attack  of  membranous  croup  some  days  previous ; and  when 
I saw  him  the  voice  had  sunk  to  a whisper,  and  the  cough  was  en- 
tirely muffled,  so  that  I had  no  doubt  of  the  fatal  termination  of  the 
case,  and  expressed  my  opinion  to  that  effect  to  the  astonished  parents. 
The  probang  had  been  used  by  the  physician  in  attendance,  which 
had  caused  so  much  suffering  that  for  the  two  days  previous  the  par- 
ents had  prohibited  its  use.  It  had  no  doubt  increased  the  irritation, 
besides  nearly  causing  strangulation. 

It  was,  therefore,  with  great  reluctance  that  they  consented  to  let 


DISEASES  OF  THE  THROAT. 


247 


me  use  the  syringe,  which  I did,  to  the  great  relief  of  the  little  suf- 
ferer, and  to  the  entire  satisfaction  of  the  parents. 

The  strength  of  the  solution  of  the  crystals  of  the  nitrate  of  silver 
used  was  20  grains  to  the  ounce  of  water,  which  I injected  freely, 
once  in  three  hours  for  the  first  day,  and  then  two  or  three  times  a 
day  for  two  or  three  days.  His  recovery  was  rapid  and  complete. 

I will  now  mention  the  case  of  a young  woman,  with  diphtheria, 
where  the  S3rringe  was  used  with  success. 

I was  called  to  see  a young  lady,  who  had  an  attack  of  diphtheria 
the  day  previous.  Found  her  in  bed,  very  much  prostrated,  breath 
ing  with  great  difficulty,  and  uttering  at  every  inspiration  a croupal 
sound,  which  at  times  was  followed  by  a short,  convulsive  cough. 
The  face  was  flushed,  pulse  124,  small  and  feeble,  and  she  complained 
constantly  of  a sense  of  suffocation  and  of  great  distress  in  the  lar- 
yngeal region. 

On  inspecting  the  throat,  the  fauces  and  the  pharyngeal  mem- 
brane, as  far  down  as  it  could  be  seen,  presented  the  appearance  of  a 
high  degree  of  inflammation.  One  of  the  tonsils  was  nearly  covered 
with  the  diphtheric  membrane,  and  the  upper  and  back  part  of  the 
throat  were  thickly  studded  with  small  wliite  or  cream-colored  spots. 

The  physician  in  attendance  had  tried  first  a swab,  or  mop,  as  she 
termed  it,  and  then  the  probang,  which  gave  her  so  much  pain  that 
he  was  obliged  to  give  it  up.  He  then  gave  up  the  case  as  hopeless. 
At  my  earnest  solicitation  she  consented  to  the  use  of  the  syringe. 
With  a solution  of  the  crystals  of  the  nitrate  of  silver,  of  the  strength 
of  60  grains  to  the  ounce  of  water,  I injected  freely  the  fauces  and 
the  upper  part  of  the  cavity  of  the  larynx.  For  a few  moments  the 
difficulty  of  breathing  and  feeling  of  strangulation  was  increased, 
but  very  soon  a large  amount  of  viscid,  ropy  mucus  was  discharged. 
In  the  course  of  half  an  hour  after  the  use  of  the  syringe,  the  symp- 
toms had  improved,  the  respira- 
tion was  less  laborious,  so  that 
in  a short  time  the  patient  ob- 
tained some  sleep.  I was  after- 
ward called,  as  she  thought  her- 
self worse,  but  found  that  an 
application  of  the  caustic  with  a syringe  was  all  that  was  required. 
There  was  no  further  trouble  with  the  case. 

These  syringes  or  similar  ones  can  now  be  bought  of  any  large 
dealer  in  surgical  instruments.  Figure  87  represents  the  syringes  as 
they  lie  in  a case. 

Mode  of  Using.  — The  glass  barrel  and  piston  of  my  instruments 
are  delicate,  but  they  need  not  be  broken.  I handle  them  with  the 
same  ease  that  I do  a spoon  in  feeding  myself,  and  not  in  a very  dis- 
similar way.  The  last  three  fingers  are  placed  on  the  under  side  of 
the  barrel,  with  the  thumb  on  the  upper  side,  — the  index  finger  be- 
ing poised  over  the  end  of  the  piston,  ready  to  drive  it  home  at  the 


248 


DISEASES  OF  THE  THROAT. 


proper  instant.  The  motion  of  the  piston  should  be  quicks  so  as  to 
cause  the  streams  to  leap  out  in  jets ; yet  delicate^  that  they  may  not 
impinge  with  too  much  force  upon  the  diseased  surfaces. 

They  should  be  rinsed  with  water  immediately  after  being  used. 
But  even  with  this  precaution,  a small  residuum  of  the  nitrate  re- 
mains and  crystallizes,  and  after  a time  partially  closes  the  holes. 
They  must  then  be  picked  out  with  the  point  of  a needle. 

When  the  silver  tube  becomes  detached  from  the  glass,  it  may  be 
fastened  on  with  common  sealing  wax  ; first  melting  the  wax  and 
sticking  it  around  the  glass;  then  heating  the  silver  over  a lamp,  and 
pressing  it  on. 

Amount  of  Solution  to  be  Used.  — The  amount  of  solution  to  be 
used  should  be  small.  Half  a dram  is  enough.  The  piston  of  the 
syringe  need  be  drawn  up  only  from  an  eighth  to  a third  of  an 
inch.  Strangling  is  not  often  produced  by  these  operations  ; but  to 
make  its  prevention  still  more  sure,  let  the  patient  be  directed  to  fill 
the  lungs  with  a long  inspiration  while  the  operator  is  depressing  the 
tongue. 

Strength  of  Solution.  — The  strength  of  the  solution  in  ordinary 
cases  of  chronic  folliculitis,  etc.,  should  generally  be  about  forty 
grains  of  the  crystals  of  the  nitrate  of  silver  to  the  ounce  of  water. 
But  in  all  acute  diseases  of  the  air  passages,  it  should  be  considerably 
stronger,  — varying  from  one  to  two  drams.  A preparation  of  this 
strength  is  powerfully  antiphlogistic  and  sedative.  In  those  cases  of 
chronic  disease,  where  the  inflammation  is  of  a low  grade,  and  the 
mucous  membrane  is  in  a relaxed,  atonic  condition,  looking  either 
sodden  and  pale,  or  of  a dark  color,  like  the  cut  surface  of  beef  some 
days  exposed  to  the  air  (as  is  often  the  case  in  throats  of  literary  dys- 
peptics), then  a solution  of  fifteen  to  thirty  grains  to  the  ounce  is 
sufficient.  This  strength  acts  as  a stimulant,  and  is  well  suited  to 
throats  in  such  condition,  but  would  be  injurious  in  high  grades  of 
inflammation.  Catarrh  in  the  head  generally  requires  only  about  this 
strength.  I am  sorry  to  say,  the  topical  mode  of  treating  throat  affec- 
tions has  been  in  some  places  injured,  in  the  public  estimation,  by  a 
lack  of  knowledge  and  judgment  on  the  part  of  the  operator,  in 
choosing  the  strength  of  his  solution. 

To  determine  the  proper  frequency  of  the  operation^  also  requires 
judgment  and  experience.  In  an  ordinary  case  of  chronic  disease, 
the  treatment  may  begin  by  showering  the  throat  once  a day  for  a 
week.  Then  the  operation  should  be  repeated  three  times  a week,  for 
a shorter  or  longer  period  ; then  twice  a week,  and  at  last  once  a week. 

Attendant  Diseases. — Among  the  persons  I am  treating  for  dis- 
eases of  the  air  passages,  many  are  dyspeptic  and  suffer  with  depres- 
sion of  spirits.  So  often  does  this  symptom  present  itself  that  I re- 
gard it  as  almost  one  of  the  peculiarities  of  throat  disease.  Persons 
thus  depressed  generally  have  the  dark  and  dingy  look  of  the  face 
which  indicates  functional  derangement  of  the  liver.  They  are  often 


DISEASES  OF  THE  THROAT. 


249 


emaciated,  nervous,  hypochondriacal,  irritable  in  temper,  and  are  ex- 
hausted by  an  excessive  secretion  of  urea.  The  urine  of  such  per- 
sons is  always  acid,  and  loaded  with  crystals  of  oxalate  of  lime. 

An  explanation  of  this  fact  has  been  attempted,  by  supposing  that 
the  oxydation  of  carbon  (of  which  these  persons  have  a superabun- 
dance), imperfectly  accomplished  in  inflamed  respiratory  organs,  is 
vicariously  effected  in  the  capillaries  of  the  kidneys, — oxalic  acid 
(C2O2)  instead  of  carbonic  acid  (COj)  being  the  result. 

The  crystals  of  oxalate  of  lime  are  octahedral  in  form,  and,  in  the 
field  of  a good  microscope,  are  beautiful  objects  for  inspection. 

Lawyers,  clerygmen,  statesmen,  and,  in  general,  those  who  labor 
hard  mentally,  with  but  little  bodily  exercise,  and  who  have  a great 
weight  of  care  resting  on  them,  are  the  persons  who  suffer  most  from 
this  complication.  Generally  the  inflammation  in  the  throat  is  of  a 
low  grade,  and  must  not  be  treated  with  a very  strong  solution  of  ni- 
trate of  silver. 

Of  course  when  these  attendant  diseases  exist,  something  more  is 
needed  than  the  local  treatment.  For  the  troubles  just  described,  the 
treatment  for  hypochondria  and  dyspepsia  will  be  proper. 

Elongation  of  the  Uvula. 

The  uvula  is  the  small  teat-like  or 
pendulous  organ  which  hangs  down 
from  the  palatine  arch,  just  over  the 
root  of  the  tongue.  It  is  very  apt  to 
get  inflamed,  and  its  parts  becoming  re- 
laxed, it  stretches  out  lengthwise,  so 
that  its  lower  extremity  sometimes  rests 
upon  the  tongue.  (Fig.  88.)  When 
this  happens,  it  flaps  about,  backward 
and  forward,  and  to  the  right  and  left, 

— touching  the  throat  at  various  points, 
and  by  the  tickling  sensation  produced, 
exciting  a most  incessant,  uncontroll- 
able, and  racking  cough.  Some  of  the 
most  distressing  coughs  I have  ever 
heard  have  been  produced  and  kept  up 
by  this  cause  alone.  Many  a fatal  con- 
sumption has  begun  in  this  way.  When 
long  inflamed,  it  often  gets  much  out 
of  shape,  being  sometimes  bent  nearly 
double. 

Treatment.  — In  some  cases,  the 
uvula,  thus  elongated,  may  be  reduced 
back  to  its  natural  size,  by  an  astrin- 
gent gargle,  composed  of  an  infusion  of 
white-oak  bark,  with  a little  alum  dis- 


FiQ.  88. 


250 


DISEASES  OF  THE  THROAT. 


solved  in  it  (232)  ; but  it  will  generally  stretch  out  again  and  again, 
upon  the  appearance  of  any  fresh  cold,  and,  therefore,  the  only  certain 
cure  is  to  cut  it  off. 

To  do  this,  take  hold  of  it  with  a pair  of  common  forceps,  and 
having  stretched  it  down  a little,  clip  it  off  above  the  forceps,  with  a 
pair  of  curved  scissors.  Nearly  the  whole  of  it  should  generally  be 
removed.  To  take  off  a part  only  leaves  a stump,  which  is  often 
more  objectionable  than  the  whole  organ.  Its  removal  never  injures 
the  speech  in  the  least.  In  'many  cases  of  nasal  catarrh,  this  organ 
is  a sort  of  diseased  centre,  from  which  inflammatory  action  spreads 
upward  into  the  nasal  cavities,  and  no  medicine  or  power  on  earth 
can  effect  a cure  until  this  offending  member  is  snipped  off. 

Acute  Inflammation  of  the  Tonsils.  — Tonsilitis. 

The  tonsils  are  chiefly  a collection  or  mass  of  small  mucous  folli- 
cles or  glands.  They  secrete  a portion  of  the  fluid  which  keeps  the 
throat  moist. 

There  is  a class  of  persons  who  suffer  about  every  winter,  some- 
times oftener,  with  an  attack  of  acute  inflammation  of  these  glands, 
which  causes  great  suffering  for  several  days.  The  trouble  usually 
is  ushered  in  by  high  fever,  backache,  headache  and  often  by  chills; 
the  temperature  often  reaches  to  103°  and  104°  F. ; swallowing  is 
difficult  on  account  of  the  swollen  glands,  while  pain  in  the  ear  is 
not  infrequent.  The  tonsils  are  at  first  swollen,  reddened  and  in- 
flamed; later  a whitish  j)atch  of  secretion  forms  on  the  surface  of 
the  gland  and  is  distinguished  from  that  of  diphtheria  by  being 
whiter  and  less  tenacious ; if  removed,  the  underlying  surface  does 
not  bleed  as  in  the  case  of  diphtheria.  It  is,  however,  very  difficult, 
at  times,  to  distinguish  between  the  two  diseases  at  first. 

Another  form  of  Tonsilitis  occurs  without  patches,  and  is  in 
reality  an  inflammation  of  the  substance  of  the  gland  itself.  This 
variety,  often  called  Quinsy,  goes  on  developing  into  an  abscess,  the 
anterior  pillar  of  the  fauces  becomes  intensely  red,  swollen  and 
shiny. 

Treatment.  — For  the  more  common  variety  some  antipyretic  to 
reduce  the  fever  and  allay  the  intense  aching  of  the  head  and  bones 
is  properly  indicated.  For  this  purpose  10  grains  of  Phenacetine 
(for  an  adult),  repeated  every  two  to  four  hours  according  to  the 
effect  produced,  is  quite  efficacious.  Ammonol  in  same  dose  may 
also  be  used.  Some  simple  astringent  and  soothing  gargle  will  next 
be  found  to  render  signal  relief.  Tannin,  30  gr.,  strong  Carbolic 
Acid  (95%),  30  drops,  Glycerin,  1 oz.,  and  peppermint  water,  3 oz.,  is 
an  admirable  garglefor  the  average  case:  this  should  be  used  hourly. 

Equal  parts  of  Glycerin,  Alcohol  and  W ater  makes  a very  sooth- 
ing  gargle,  while  equal  parts  of  Peroxide  of  Hydrogen  and  Water  is 
preferred  by  many.  The  diet  should  be  limited  in  amount  and  con- 
sist only  of  liquids. 


DISEASES  OF  THE  THROAT. 


251 


Tincture  of  aconite  in  1 or  2 drop  doses  together  with  half  teaspoon- 
ful of  sweet  spirits  of  nitre  repeated  every  hour  will  help  to  allay  the 
fever  and  congestion  of  the  throat,  and  goes  far  to  prevent  pus  forma- 
tion which  is  usually  spoken  of  as  Quinsy  sore  throat.  This  abscess, 
if  formed,  may  be  evacuated  by  the  physician,  who  alone  should  at- 
tempt it,  as  the  region  is  a dangerous  one,  being  close  to  the  carotid 
artery  and  jugular  vein,  which  would  cause  instant  death  if  cut. 

It  has  been  found  that  Tonsilitis  is  apt  to  be  recurrent  and  that 
he  who  has  suffered  once  is  very  prone  to  have  one  or  more  attacks 
annually  thereafter.  This  class  requires  constitutional  treatment  in 
the  intervals  as  outlined  below. 

These  inflammations  are  likewise  found  to  be  an  expression  often- 
times of  rheumatism,  and  need  corresponding  treatment.  But  the 
only  cure  is  to  be  found  by  cutting  off  the  tonsils,  after  the  inflam- 
mation  has  subsided.  This  will  put  an  end  to  the  attacks  at  once. 

Tonsils  which  are  subject  to  these  periodical  attacks  of  acute  in- 
flammation are  always  more  difficult  than  others  to  operate  upon,  as 
they  are  almost  invariably  bound  down  very  tight  to  the  throat,  and 
cannot  be  raised  up  for  convenient  excision. 

Chronic  Inflammation  of  the  Tonsils. 

In  many  of  the  follicular  diseases  of  the  throat,  these  glands  are 
affected  by  a chronic  inflammation,  and  are  found  enlarged,  and 
sometimes  very  much  hardened.  In  such  cases  they  secrete  a thin, 
unhealthy,  irritating  fluid,  which  is  spread  over  the  throat,  increasing 
and  perpetuating  its  disease.  Much  of  this  secretion  finds  its  way 
into  the  stomach,  and  thence  into  the  circulation. 

In  the  throats  of  many  young  persons  and  children,  these  glands 
ure  permanently  so  large  as  nearly  to  fill  the  fauces.  The  respiration 
of  many  children  thus  afflicted  is  difficult,  and  when  asleep  they  can 
only  breathe  with  the  mouth  open.  The  defective  breathing  of  such 
children  often  occasions  contractions  of  the  chest,  and  thus  lays  the 
foundation  for  consumption.  From  these  diseased  parts,  the  inflam- 
mation often  spreads  upwards,  into  the  posterior  nares,  and  many 
times  enters  the  eustachain  tubes,  causing  deafness  or  pain  in  the  ears. 
Such  children  often  breathe  as  though  they  had  a bad  cold  in  the 
head.  Their  health  and  safety  require  an  immediate  attention  to 
this  state  of  things. 

Chronic  inflammation  of  the  tonsil,  likewise  the  recurrent  acute 
form,  maybe  dependent  on  poor  blood  or  rheumatism.  Those  causes 
are  met  by  blood-building  medicines  like  Syrup  of  the  Iodide  of  Iron 
in  10-drop  doses  three  times  daily,  cod  liver  oil,  and  by  some  one  of 
the  many  preparations  of  iron,  arsenic,  and  strychnia  combinations. 
It  is  found  that  generally  the  excision  of  the  tonsil  may  be  averted 
by  visiting  the  surgeon,  who  will  hunt  out  the  little  crypts  or  holes 
with  which  the  gland  is  studded,  and  by  gently  cutting  the  narrow 


252 


DISEASES  OF  THE  THROAT. 


bridges  which  separate  these  holes,  destroy  these  cavities.  These 
little  holes  retain  small  particles  of  food  and  decomposed  secretion, 
which  after  a while,  if  allowed  to  remain,  set  np  a follicular  tonsil- 
itis.  The  size  of  the  gland  is  thus  greatly  diminished  and  the  little 
secreting  follicle  destroyed.  Many  a little  sufferer  can  thus  be  spared 
the  harsher  method  of  excision,  and  bear  with  good  grace,  especially 
if  cocaine  be  used,  what  otherwise  might  be  a painful  and  bloody 
operation.  But,  as  has  been  said,  excision  in  many  cases  must  be 
resorted  to. 

Curability  of  Throat  Diseases.  — I have  dwelt  somewhat  upon 
the  preceding  forms  of  throat  disease,  because  they  prevail  to  a fear- 
ful extent,  and  are,  in  thousands  of  cases,  but  the  first  stages  of  fatal 
disease  of  the  lungs. 

If  not  connected  with  lung  disease  in  the  beginning,  my  experience 
in  treating  them  enables  me  to  say,  emphatically,  they  are  generally 
curable. 

But  patients  often  put  the  question  to  me  — “ If  cured,  will  I ever 
have  the  complaint  again?”  My  answer  is  — “ Unless  I can  plant 
in  your  constitution  a better  protection  than  your  Maker  put  there  at 
your  creation,  you  will  of  course  be  liable  to  a second  attack.”  But 
then,  where  the  lungs  have  been  entirely  free  from  disease,  I have 
never  yet  seen  a case  of  simple  throat  complaint  relapse  and  become 
dangerous  after  proper  treatment  with  the  syringes.  Let  not  those, 
therefore,  who  have  been  benefited,  but  not  entirely  cured  by  this 
treatment,  undervalue  what  has  been  done  for  them.  Even  in  such 
cases,  the  advantage  derived  to  them  amounts  to  just  the  value  they 
attach  to  the  continuance  of  life. 

Dangers  of  Delay.  — In  closing  these  remarks,  let  me  warn  the 
reader  against  the  dangers  of  delay.  Many  of  those  who  finally  seek 
medical  attendance  in  these  complaints,  first  try  all  nostrums,  and 
tamper  with  their  disease  till  the  case  is  either  critical  or  hopeless. 
Too  many  wait  till  they  are  near  enough  to  the  engulfing  whirlpool 
to  hear  it  roar,  before  they  seek  in  any  practicable  way  to  escape  its 
dangers. 

Many  persons  neglect  a slight  inflammation  of  the  pharynx,  which 
might  have  been  cured  in  a few  days,  but  which,  from  long  neglect, 
has.  gradually  crept  down  the  windpipe,  spread  over  the  widely  dis- 
tributed mucous  lining  of  the  bronchial  tubes,  and  thus  become  cur- 
able only  in  a partial  degree,  and  after  long  and  tedious  treatment. 
Hundreds  of  persons  are  now  suffering  from  slight  attacks  of  this 
sort,  who  might  be  rid  of  the  affliction  in  a week  or  a fortnight,  but 
who  will  either  carelessly  give  it  no  attention  at  all,  or  resort  to  use- 
less nostrums,  until  it  has  run  tlirough  its  primary  stages  and  invaded 
the  constitution,  and  will  finally  die  of  some  of  the  forms  of  pulmo- 
nary disease. 


DISEASES  OF  THE  THEOAT. 


253 


A Cold.  — Influenza. 

A SLIGHT  attack  of  the  disease  about  to  be  described,  aifecting  only 
here  and  there  a person,  and  lasting  only  for  a few  days,  is  called  a 
cold.  When  it  affects  a large  part  of  the  community  at  the  same 
time,  lasting  many  days,  or  even  weeks,  it  is  then  an  epidemic,  and 
passes  under  the  name  of  influenza.  In  this  latter  form,  it  sometimes 
spreads  over  a whole  country,  and  has  at  times,  as  in  1832  and  1894, 
extended  to  nearly  the  whole  civilized  world.  It  often  shows  marked 
severity  in  its  progress,  and  leaves  serious  results  behind. 

. Symptoms. — A tingling,  with  dryness,  and  a sense  of  fulness  in 
the  mucous  membrane  of  the  nose,  are  among  the  first  indications  of 
an  attack  of  this  complaint.  Sneezing  is  a common  symptom.  Soon 
pain  is  felt  in  the  forehead,  and  breathing  through  the  nose  becomes 
difficult.  The  eyes  are  red  and  watery,  the  throat  is  sore ; there  is  a 
dry  cough,  hoarseness,  thirst,  general  lassitude,  chills,  and  a desire 
to  get  near  the  fire.  The  mucous  membrane  of  the  nose,  throat, 
windpipe,  and  breathing-tubes  is  inflamed,  red,  swollen,  and  some- 
times painful. 

In  a short  time,  water  begins  to  run  from  the  nose  and  eyes,  and 
the  cough  becomes  a little  more  moist.  There  is  also  a slight  dis- 
charge from  the  throat  and  tubes,  which  gradually  increases,  and,  at 
length,  as  the  disease  deelines,  and  becomes  less  acute,  the  expectora- 
tion is  thick  and  yellow. 

Aching  of  the  back  and  limbs,  thirst,  loss  of  appetite,  flashes  of 
heat,  and  chills  whenever  the  patient  is  exposed  to  air  a little  cooler 
than  he  is  accustomed  to,  are  almost  constant  attendants  upon  the 
disease. 

Causes.  — It  is  not  always  easy  to  say  what  the  causes  of  this  com- 
plaint are.  Frequently,  it  can  be  traced  to  an  improper  exposure  to 
cold  or  dampness ; but  in  a great  majority  of  cases,  especially  when 
it  takes  the  form  of  influenza,  the  causes  are  not  obvious.  They 
probably  exist  in  some  peculiar  states  of  the  atmosphere,  and  in  a 
depression  of  the  nervous  system. 

The  influence  upon  disease  of  the  different  degrees  of  density  in 
the  air  which  surrounds  us,  and  of  other  circumstances  affecting  it, 
have  not  been  much  studied.  Some  valuable  facts  will  be  drawn 
from  this  source  before  many  years.  The  putting  upon  the  body,  or 
taking  from  it,  several  tons  of  pressure  every  time  the  barometer  rises 
or  falls,  must  have,  of  itself,  no  small  influence  upon  its  health.  The 
comparatively  new  science  of  Physical  Geography,  by  spreading  be- 
fore us  its  interesting  facts  in  regard  to  temperature,  storms,  atmos- 
pheric currents,  etc.,  is  opening  the  way  for  the  physician  to  learn  a 
great  deal  more  about  the  causes  of  disease  than  he  now  knows. 

Treatment. — In  mild  cases,  only  the  most  simple  treatment  is  re- 
quired,— such  as  remaining  in  the  house  for  a few  days,  soaking  the 


254 


DISEASES  OF  THE  THROAT. 


feet  in  warm  water,  taking  a gentle  sweat,  drinking  warm  infusions 
of  flax-seed,  mullein,  slippery  elm,  or  warm  lemonade,  and  taking 
only  a spare  vegetable  diet.  If  the  bowels  be  costive,  some  gentle 
physic  (34),  (41)  may  be  used,  A laxative  drink  (132)  will  like- 
wise  be  useful. 

At  the  outset,  especially  when  the  nose  runs  water,  a small  dose  of 
atropia,  ^ ^ grain,  taken  every  two  hours  till  the  throat  is  dry,  wiU 
entirely  arrest  the  disease  at  this  point.  The  coryza  pill  found  at 
the  druggists’  is  a more  valuable  remedy  still. 

When  the  attack  is  more  severe,  sweating  must  be  induced  by  de- 
cisive measures.  This  may  be  affected  by  the  spirit  vapor-bath,  or, 
by  putting  the  patient  in  bed,  putting  bottles  of  hot  water  to  the  feet 
and  sides,  and  administering  warm  drinks,  and  the  compound  tinc- 
ture of  Virginia  snakeroot.  Five  drops  every  hour  of  the  tincture 
of  veratrum  viride  will  often  cause  very  free  perspiration,  and  will 
reduce  the  inflammation  upon  the  mucous  surface. 

An  emetic  is  sometimes  very  useful.  To  produce  vomiting,  use 
the  powder  of  ipecac,  ten  to  twenty  grains,  or  the  compound  tincture 
of  lobelia. 

It  soothes  the  inflamed  mucous  surfaces  very  much  to  inhale  the 
vapor  from  half  a pint  of  hot  water,  with  five  drops  of  tincture  of 
veratrum  viride,  or  the  same  amount  of  the  tincture  of  aconite  root. 

If  the  cough  is  severe,  use  the  preparations  recommended  under 
bronchitis  and  consumption. 

In  the  latter  stages  of  the  disease,  if  there  be  debility,  — as  there 
generally  is, — quinia,  iron,  nux  vomica,  etc.  (75),  should  be  taken  ; 
or,  to  support  the  nervous  system,  the  extracts  of  scullcap,  and  bone- 
set,  and  the  sulphate  of  quinia  (81)  will  be  found  useful.  At  this 
stage  of  the  complaint,  the  diet  should  be  more  liberal  and  nourishing. 

The  patient  should  not  venture  into  the  open  air  until  the  unpleas- 
ant sense  of  chilliness,  peculiar  to  the  disease,  ceases  to  be  produced 
by  exposure. 

La  Grippe. 

This  is  a variety  of  influenza  with  which  the  world  has  become 
well  acquainted  within  the  last  few  years.  Its  history  is  interesting 
and  its  symptoms  and  results  are  severe  and  annoying.  It  is  one  of 
the  most  severe  forms  of  catarrhal  disease  of  the  nose  or  throat  with 
which  we  are  acquainted.  It  owes  its  origin  to  a germ  which  found 
its  biidh  in  the  filth  and  pollution  of  eastern  Europe,  and  has  visited 
the  globe  with  terrible  ravages  on  several  occasions  since  the  Middle 
Ages.  It  spreads  by  travelling  the  most  frequented  paths  of  com- 
merce, and  attacks  those  in  a depressed  state  of  health.  The  varieties 
of  la  grippe  are  as  numerous  as  that  of  any  other  disease.  The  catar- 
rhal form  is  much  like  that  of  ordinary  head  influenza,  only  it  is  more 
severe  and  prostrating;  the  bronchial  assumes  the  influenza  type,  at 
first,  but  soon  attacks  the  lungs  and  sets  up  a severe,  prolonged  and 


255 


DISEASES  OF  THE  THBOAX 

harassing  bronchitis ; the  intestinal  variety,  besides  producing  the 
general  symptoms  of  malaise,  fever,  cough,  severe  aches  and  pains, 
gives  rise  to  a diarrhoea  which  lasts  many  days  and  is  very  debilita- 
ting; the  most  common  variety,  however,  is  the  rheumatic,  which  is 
ushered  in  by  chills,  fever,  muscular  pains,  coryza,  cough  and  general 
rheumatic  pains.  The  characteristic  feature  of  all  of  these  forms  is 
the  great  prostration  which  accompanies  these  symptoms  and  the  ob- 
stinacy with  which  it  clings  to  the  patient. 

The  sequelae  of  the  disease,  though  much  exaggerated,  are  numer- 
ous. The  aged  are  often  left  infirm  with  heart  weakness,  the  young 
with  lessened  resistance  to  disease,  and  the  middle-aged  with  chronic 
coughs. 

Many  an.  undiscovered  disease  has  passed  unnoticed  under  the  dis- 
guise of  “ la  grippe.”  It  has  no  doubt  served  as  a broad  mantle  to 
cover  our  ignorance  of  real  disease  and  been  made  an  easy  refuge  for 
the  complaining;  still  its  affects  at  times  cannot  be  over-estimated, 
and  death  has  not  infrequently  resulted. 

T reatment. — The  onset  is  to  be  met  with  large  doses  of  quinine, 
say  10  grains  on  retiring,  by  phenacetine  and  salol,  10  grains  each, 
taken  with  some  hot  lemonade  on  retiring.  This  latter  may  be  re- 
peated every  three  hours.  The  coryza  is  checked  by  small  repeated 
doses  of  belladonna,  camphor  and  quinine,  as  found  in  the  coryza 
tablets  bought  at  the  druggist’s  — one  taken  every  two  hours  till  the 
throat  is  dry,  then  once  in  four  to  eight  hours.  The  debility  is  to 
be  met  by  tonics. 

Acute  Inflammation  of  the  Epiglottis. 

This  is  the  disease  by  which  our  country  lost  its  most  loved  and 
distinguished  citizen,  George  Washington.  This  complaint  was  not 
understood  at  the  time  of  his  death,  — the  intelligent  physicians  who 
attended  him  supposing  it  to  be  inflammation  of  the  windpipe.  From 
their  very  clear  description  of  the  symptoms,  we  now  know  it  to  have 
been  an  acute  inflammation  of  the  epiglottis  and  glottis. 

From  the  rapid  inflammation  of  the  epiglottis,  water  is  effused  into 
this  cartilage,  so  as  to  puff  it  up,  and  prevent  it  from  shutting  down 
in  the  act  of  swallowing.  The  lips  of  the  glottis  are  swollen  from 
the  same  cause,  and  brought  so  near  to  each  other  that  air  passes 
through  to  the  lungs  with  great  difficuly,  and  unless  relief  is  soon 
obtained,  the  patient  is  strangled. 

Symptoms. — The  disease  begins  with  a severe  chill,  accompanied 
with  some  pain,  and  a sense  of  stricture  or  tightness  in  the  upper  and 
fore  part  of  the  throat.  There  is  cough,  with  difficult  and  sometimes 
painful  swallowing.  These  symptoms  are  soon  followed  by  quick 
and  laborious  breathing.  Speaking  aloud  is  from  the  first  difficult, 
and  soon  becomes  impossible.  As  the  complaint  runs  its  rapid  course, 
the  breathing  grows  more  difficult,  and  death  soon  results  from  com- 
plete strangulation. 


256 


DISEASES  OF  THE  THKOAT. 


Treatment. — Apply  immediately  to  the  paids  a strong  solution  of 
nitrate  of  silver.  The  solution  should  be  of  the  strength  of  ninety 
to  one  hundred  and  twenty  grains  to  the  ounce  of  soft  water.  It 
should  be  applied  every  hour  or  two  till  the  feeling  of  suffocation 
subsides,  and  should  be  done  with  the  laryngeal  shower  syringe, 
though  if  this  is  not  at  hand  the  sponge  probang  may  be  used. 

While  this  local  treatment  is  being  employed,  liberal  doses,  from 
five  to  twenty  drops,  of  tincture  of  veratrum  viride  should  be  given 
every  hour,  watching  the  effect,  and  discontinuing  when  the  pulse 
sinks  too  low. 

Hot  fomentations  applied  externally,  and  filling  the  room  with 
steam,  as  recommended  in  cases  of  croup,  would  be  useful. 

Mumps.  — Parotitis.  * 

This  disease  appears  most  often  among  children ; but  as  it  is  not 
confined  to  them,  I have  not  placed  it  among  their  complaints. 

Symptoms. — It  begins  with  soreness  and  stiffness  in  the  side  of 
the  neck.  Soon  a swelling  of  the  parotid  gland  takes  place,  which  is 
painful,  and  continues  to  increase  for  four  or  five  days,  sometimes 
becoming  very  large,  and  making  it  difficult  to  swallow,  or  open  the 
mouth  to  receive  food.  After  the  fourth  or  fifth  day  the  swelling 
subsides,  and  disappears  in  from  seven  to  ten  days. 

Both  glands  generally  swell  about  the  same  time,  but  sometimes 
the  swelling  appears  in  one  only  after  it  has  subsided  in  the  other, 
and  occasionally  the  swelling  is  wholly  confined  to  one  side. 

When  the  swelling  is  great,  there  is  heat,  and  sometimes  fever, 
with  dry  skin,  quick  pulse,  furred  tongue,  constipated  bowels,  and 
scanty  and  high-colored  urine. 

The  affection  is  sometimes  translated,  as  we  say ; that  is,  in  females, 
the  breast  swells,  and  in  males,  the  testicles  become  swollen  and  pain- 
ful. This  accident  generally  happens  in  consequence  of  taking  cold 
from  some  imprudence. 

The  disease  is  contagious ; that  is,  it  is  communicated  fr^m  one 
person  to  another. 

Treatment. — In  mild  cases,  very  little  treatment  is  required. 
Keeping  the  face  and  neck  warm,  avoiding  exposure  to  cold  and 
damp,  drinking  warm  infusions  of  balm,  spearmint,  or  sage,  and  ap- 
ply a poultice  of  flax-seed  over  the  glands  until  the  patient  is  fully 
relieved ; or  the  compound  powder  of  jalap,  if  there  be  costiveness, 
is  about  all  that  is  required.  The  diet  should  consist  of  rye  hasty 
pudding,  or  brown  bread  and  sweetened  water. 

If  the  case  be  severe,  and  other  glands  swell,  physic  must  be  freely 
used,  leeches  must  be  applied,  and  cooling  lotions,  or  poultices. 
Sweating  must  also  be  induced  by  the  compound  tincture  of  Vir- 
ginia snakeroot,  or  by  a vapor  bath. 


DISEASES  OF  THE  THEOAT. 


257 


In  young  girls  mumps  often  attack  the  ovaries  and  make  the  in- 
valid a great  sufferer  for  a few  days  ; the  testicle  of  the  male  is  simi- 
larly affected  at  times.  These  complications  call  for  soothing  appli- 
cations and  rest  in  bed. 


DISEASES  of  the  CHEST 


DISEASES  OP  THE  CHEST. 

(Also  see  Anatomy  of  the  Lungs  and  Respiratory  Organs.) 


Consumption.  — Phthisis. 

As  it  was  asserted  a short  time  ago  that  the  incurability  of  con- 
sumption was  an  acknowledged  fact,  it  is  encouraging  to  know  that 
in  many  instances  now  we  may  effect  a cure  even  under  relatively 
poor  conditions,  also  that  many  persons  have  the  disease  and  get 
well  of  it  without  their  knowledge.  This  is  proved  by  the  large  num- 
ber of  cases  that  have  come  to  autopsy  for  death  from  some  other 
cause  and  the  diseases  of  the  lung  which  has  healed  are  discovered. 
If  the  disease  can  be  taken  in  hand  early  enough  and  the  constitu- 
tion of  the  person’s  body  protected  from  these  ravages  by  appropriate 
climatic  conditions,  good  food,  and  possibly  a little  medicine,  we  are 
justified  in  thinking  that  a favorable  outcome  will  occur.  It  is  neces- 
sary to  keep  the  weight  of  the  person  maintained  and  especially  the 
digestion  more  than  good. 

Marriage  should  be  avoided  by  anyone  afflicted  with  the  disease, 
as  the  bearing  of  children  on  the  part  of  the  woman  will  often  cause 
the  disease  to  take  a fresh  start  and  the  extra  effort  required  by  the 
husband  to  maintain  his  family  will  do  the  same  for  him.  It  is  only 
fair  to  the  friends  surrounding  the  patient  that  precautions  should  be 
taken  to  prevent  the  contraction  of  this  disease  from  one  whom  they 
are  trying  to  help,  as  the  disease  is  propagated  by  the  increase  of 
the  germ  known  as  the  bacillus  of  tuberculosis;  we  must  destroy 
this  organism  as  soon  as  it  is  expelled  from  the  person. 

In  the  expectoration  these  germs  are  present  in  very  large  numbers 
and  in  singing  and  coughing  they  are  sent  into  the  air  to  possibly  be 
inhaled  and  land  on  new  soil  for  future  trouble.  The  kiss  of  a con- 
sumptive is  very  dangerous  and  even  the  use  of  toilet  articles  which 
have  been  used  to  wipe  the  nose  or  mouth  is  dangerous  until  they 
have  been  boiled.  All  expectoration  should  be  received  in  articles 
which  can  be  burned  before  they  become  dried,  and  if  the  person  is 
confined  to  the  house  they  may  be  received  in  an  earthen  vessel 
which  holds  a solution  of  disinfectant  such  as  carbolic  acid,  1 part 
of  the  pure  acid  to  20  of  water,  or  corrosive  sublimate,  1 part  to  a 
1000. 

It  is  for  this  reason  that  the  boards  of  health  of  all  the  large  cities 
of  the  United  States  and  Europe  within  the  past  few  years  have  passed 
ordinances  prohibiting  expectoration  of  sputum  on  the  sidewalks,  floors 
of  cars,  at  stations  or  public  places,  and  the  disease  is  now  reported  to 

259 


260 


DISEASES  OF  THE  CHEST. 


them  by  physicians  under  penalty  of  fine  in  the  same  manner  as  small- 
pox and  diphtheria.  Sunlight  is  another  prevention,  for  this  germ 
cannot  live  in  the  rays  of  the  sun  and  this  is  taken  into  account  in 
our  treatment  of  the  patient,  as  good  air  and  sunlight  are  perhaps 
the  most  important  aids  in  helping  us  to  get  the  better  of  the  disease. 

Methods  of  Examining  the  Chest. — Before  speaking  further  of 
consumption,  I propose  to  do  what  has  never  been  done,  namely,  to 
instruct  the  general  reader  very  briefly  in  the  method  of  examining 
the  chest  to  learn  the  existence  of  disease.  Perhaps  this  will  be 
considered  a departure,  in  some  slight  degree,  from  my  purpose  to 
make  this  entire  book  intelligible  to  the  general  reader.  If  so,  my 
reply  is,  that  there  are  many  school  teachers,  mechanics,  masters  of 
vessels,  and  farmers,  who  have  inquiring  minds,  and  sagacity  enough 
to  learn  the  physical  signs  of  chest-disease,  and  to  make  them,  in 
many  cases,  practically  useful ; and  that  even  readers  of  little  re- 
flection cannot  fail  to  comprehend  a portion  of  my  explanations. 

Position  of  the  Patient.  — In  performing  percussion  upon  the 
front  of  the  chest,  the  patient  should  be  required  to  sit  in  a square 
position,  with  the  arms  hooked  over  the  corners  of  the  back  of  the 
chair,  and  the  head  thrown  a little  back. 

Instrument  with  which  to  Thump.  — The  index  and  middle 
fingers  of  the  right  hand  are  to  he  brought  together,  into  a line,  and 
used  as  the  percussing  instrument.  The  blow  given  with  these  is  to 
be  smart  and  quich,  rather  than  heavy. 

Medium  to  Thump  Upon.  — Either  the  index  or  middle  finger  of 
the  left  hand  is  to  be  pressed  firmly  upon  the  surface  of  the  chest  to 
be  percussed  or  struck,  and  thus  used  as  a pleximeter. 

Auscultation.  — Listening  for  the  purpose  of  hearing  within  the 
chest  the  sounds  produced  by  breathing,  talking,  coughing,  etc.,  is 
called  auscultation. 


Fig.  90.  Fig.  91. 

Instruments  with  which  to  Listen.  — The  naked  ear  is  generally 
considered  best  for  hearing  low  and  delicate  sounds  ; but  for  hearing 


DISEASES  OF  THE  CHEST. 


261 


loud  and  rough  ones,  it  is  not  so  good  as  the  stethoscope,  repre- 
sented hy  Fig.  90.  A still  better  instrument  is  the  double-eared 
stethoscope,  Fig.  91.  It  magnifies  the  sounds  very  much,  and  is  apt 
to  confuse  an  examiner  not  accustomed  to  it ; but  when  the  ear  is 
once  familiar  with  it,  the  aid  it  affords  is  very  valuable. 

The  examiner  should  pass  from  side  to  side,  continually  comparing 
the  sounds  upon  one  side,  with  those  upon  the  other. 

The  patient  must  be  calm,  and  the  examiner  in  no  hurry. 

Healthy  5ounds.  — To  become  skilful  either  in  percussion  or  aus- 
cultation, the  examiner’s  ear  must  first  be  trained  to  healthy  sounds. 

These  are  best  heard  in  the  child,  in  whom  they  are  louder  than 
in  the  adult. 

In  describing  the  healthy  sounds  in  the  different  regions  of  the 
chest,  I shall  refer  the  reader  constantly  to  Figs.  92  and  93. 

Clavicular  Region.  — This,  in  Fig.  92,  is  represented  by  1,  1. 
Upon  thumping  upon  the  collar-bones,  the  sound  given  out  at  the 
breast-bone  end  should  he  veiy  clear ; less  clear  in  the  middle ; and 
dull  at  the  shoulder  end. 

Subclavian  Region.  — This  is  represented  by  2,  2,  and  lies  be- 
tween the  collar-bone  and  the  fourth  rib,  on  both  sides.  It  covers  a 
considerable  portion  of  the  upper  lobe  of  the  lungs.  The  sound 
upon  striking  this  place  should  he  very  clear. 


Fig.  92.  Fig.  93. 


The  Mammary  Region,  represented  by  3,  3,  extends  from  the 
fourth  to  the  seventh  rib,  on  each  side.  In  the  upper  part  of  this 
region,  the  healthy  sound  is  clear ; but  at  the  bottom  of  it,  on  the 
right,  the  sound  is  deadened  by  the  liver ; on  the  left,  by  the  heart. 


262 


DISEASES  OP  THE  CHEST. 


The  Infra=Mammary  Region,  4,  4,  lies  between  the  seventh  rib 
and  the  edge  of  the  cartilages  of  the  false  ribs.  On  the  right  side, 
the  liver  makes  the  sound  dull ; but  under  the  left  side  lies  the 
stomach,  which  is  hollow,  and  the  sound  is  generally  quite  loud. 

In  the  Sternal  Region,  5,  6,  T,  which  covers  the  breast-bone,  the 
jound  is  generally  clear. 

The  Axillary  Region,  8,  8,  is  in  the  arm-pits.  In  this  the  sound 
should  be  clear. 

The  Lateral  Region,  9,  9,  is  immediately  below  the  above,  and 
yields,  likewise,  a clear  sound. 

The  Lower  Lateral  Region,  gives  a dull  sound  on  the  right  side, 
and  on  the  left  a very  hollow  one. 

Fig.  93  represents  the  hack  part  of  the  chest.  In  looking  at  this, 
we  see  the 

Acromial  Region,  represented  by  11, 11.  In  this  space  the  sound 
’s  dull,  but  it  has  not  much  meaning. 

The  Scapular  Region,  12,  12,  covers  the  part  occupied  by  the 
shoulder-blades.  It  gives  rather  a dead  sound. 

The  Intra=Scapular  Region,  13,  13,  lies  between  the  shoulder- 
blades,  on  each  side  of  the  back  bone.  If  the  patient’s  arms  are 
crossed,  and  the  head  bent  forward,  a clear  sound  will  be  obtained. 

The  Dorsal  Region,  14,  14,  covers  the  base  of  the  lungs,  and,  in 
health  gives,  a clear  sound. 

Observation.  — If,  now,  on  thumping  upon  the  chest,  we  find  a 
dull,  dead  sound  in  any  spot  where  a clear  one  ought  to  be  yielded, 
we  are  to  conclude  that  underneath  there  is  not  the  usual  quantity 
of  air ; but  we  cannot  tell  merely  by  percussing,  whether  tubercles 
are  deposited  there,  or  the  lung  has  become  solid  by  inflammation, 
or  water  has  been  poured  out  into  the  cavity  of  the  pleura.  This 
point  must  be  determined  by  auscultation,  etc,,  to  be  explained 
gradually  as  we  go  along. 

Auscultation  of  Breathing.  — On  applying  the  ear  or  the  stetho- 
scope to  the  chest,  two  sounds  are  heard  which  immediately  succeed 
each  other,  — the  louder  is  produced  by  the  ingoing  breath,  or  in- 
spiration ; the  weaker  by  the  outgoing  breath,  or  expiration.  These 
sounds  will  be  further  explained  as  we  go  along. 

Auscultation  of  the  Voice  and  Cough.  — The  chest  of  a healthy 
person  speaking  communicates  to  the  ear  no  distinct  sound,  but  only 
a vibratory  sensation,  called,  in  technical  language,  the  pectoral  fre- 
mitus. 

Over  the  larynx  and  windpipe,  the  examiner  may  hear  natural 
pectoriloquy ; between  the  shoulder  blades,  in  the  space  correspond- 
ing to  the  roots  of  the  lungs,  natural  bronchophony. 


DISEASES  OF  THE  CHEST. 


263 


Philosophy  of  Chest  Sounds.  — The  fullness  and  clearness  oi 
sound  upon  percussion,  depends  upon  the  amount  of  air  in  the  chest. 

The  sounds  called  breathing  murmurs,  are  caused  by  the  expansion 
and  contraction  of  the  air-cells  or  vesicles,  as  the  air  passes  in  and 
out ; hence  they  are  called  vesicular  murmurs. 

The  friction  of  the  air  against  the  sides  of  the  windpipe  and  large 
bronchial  tubes  causes  the  blowing  sound  heard  in  those  parts. 

In  children  a larger  amount  of  air  enters  the  lungs,  and  the  air 
vesicles  are  expanded  with  more  force ; hence  their  breathing  has  a 
iouder  sound,  which  is  called  puerile  respiration.  This  kind  of 
breathing,  heard  in  the  grown  person,  is  a sign  of  disease. 

The  lung  tissue  is  a bad  conductor  of  sound ; and  the  voice  is  ac- 
cordingly heard  only  over  those  parts  where  large  bronchial  tubes 
are  near  the  surface ; heard  elsewhere,  it  indicates  disease. 

Division  of  Consumption.  — Consumption  may  be  divided  into 
two  kinds,  the  tubercular  and  the  bronchial.  The  former  has  a con- 
stitutional, the  latter  a local  origin. 

First  Stage  of  Tubercular  Consumption. 

Physical  Signs.  — Dullness  of  sound  on  and  under  the  collar- 
bones. Inspiration  shortened;  expiration  augmented  both  induration 
and  intensity.  This  dullness  often  first  perceived  in  armpits,  or  at 
base  and  back  of  lungs. 

Occasionally  a pulmonary,  crumpKng  sound.  Dry,  crackling  rat- 
tles. 

The  resounding  of  the  voice  increased  at  the  top  of  the  lungs. 

General  Symptoms.  — A sense  of  weariness  and  languor. 

Occasionally,  slight,  flying  pains  about  the  chest  and  shoulders. 

A peculiar  sensitiveness  to  the  effects  of  cold. 

Breathlessness  on  moving  quick,  or  ascending  a hill  or  stairs. 

In  many  cases  a blue  lividity  of  the  lips  and  roots  of  the  finger- 
nails, and  coldness  of  the  hands  and  feet. 

Occasionally,  in  females,  even  at  this  early  stage,  a cessation  of 
the  monthly  turns.  These  usually  stop  later  in  the  disease. 

Observations.  — The  formation  of  tubercles  almost  always  begins 
at  the  top  of  the  lungs.  Laennec  and  others  thoHght  they  appeared 
oftenest  on  the  right  side  first;  Louis,  Andral  Watson,  Sir  James 
Clarke,  and  others,  believed  they  appeared  more  often  on  the  left  side. 
Recent  investigations  show  that  they  were  all  mistaken.  Tubercles 
appear  first  about  as  often  upon  one  side  as  upon  the  other. 

The  pulmonary  crumpling  sound  is  caused  by  a mechanical  ob- 
struction to  the  expansion  of  the  lungs.  It  is  generally  heard  only 
during  the  drawing  in  of  the  breath.  The  sound  is  like  that  pro- 
duced by  blowing  upon  very  fine  paper. 


264 


DISEASES  OF  THE  CHEST. 


Second  Stage. 

Physical  Signs.  — Marked  dullness  of  sound  on  the  collar  bones, 
and  extending  below  them. 

Inspiratory  murmur  diminished  in  duration  and  intensity ; expira- 
tory murmur  augmented  in  both. 

In  upper  lobes  of  lungs,  moist,  crackling  rattles,  succeeded  by 
mucous  rattles.  Also  bronchial  respiration,  or  tubular  breathing. 

In  lower  lobes  of  lungs,  puerile  respiration. 

Sounds  of  the  heart  heard  under  the  collar  bones. 

Bronchophony  heard  in  the  same  parts  as  bronchial  respiration. 

General  Symptoms.  — A quickened  pulse;  slight  fever  towards 
evening,  oftentimes  amounting  to  quite  high  fever. 

Great  susceptibility  to  the  effects  of  cold,  and  liability  to  take  cold 
easily. 

Bowels  generally  costive ; oftentimes  seat  of  pain. 

The  eye  has  a peculiar  whiteness  and  lustre. 

The  skin  and  mouth  become  dry  in  the  afternoon ; chills  occur 
about  midday,  followed  by  fever,  during  which  the  cheeks  are  flushed. 

As  the  second  stage  advances  to  its  close,  a dry,  burning  heat 
afflicts  the  palms  of  the  hands  and  soles  of  the  feet. 

Night-sweats  occur  at  this  time. 

Observations.  — A hollow,  elastic  body,  containing  air,  gives, 
when  struck,  a clear  sound.  The  dullness  of  sound  on  percussing 
the  chest,  arises  from  the  absence  of  air  in  the  air-cells,  — these 
having  been  pressed  together,  or  obliterated  by  the  deposit  of  a mass 
of  tubercles.  The  destruction  of  these  cells  causes  the  cessation  of 
the  respiratory  murmur. 

This  stage  of  the  disease  is  often  accompanied  by  an  inflammation 
of  the  mucous  membrane  lining  the  air-tubes.  The  air,  pushing  its 
way  through  the  mucous  secretions  in  these  tubes,  forms  bubbles,  the 
bursting  of  which  causes  the  rattle.  The  crepitant  rattle  is  produced 
by  inflammation  around  the  tubercles.  The  moist,  crackling  rattle 
is  caused  by  the  softening  of  the  tubercles. 

The  lungs,  rendered  more  solid  by  the  deposit  of  tubercles,  become 
better  conductors  of  sound ; and  this  causes  the  beating  of  the  heatt 
to  be  heard  as  far  off  as  under  the  collar  bones. 

Bronchial  respiration  gives  the  idea  of  air  blown  through  a tube ; 
cavernous  respiration,  of  air  passing  into  a large  enclosed  cavity. 


Third  Stage. 

Physical  Signs.  — In  this  stage  cavities  are  formed.  If  the  cavi- 
ties be  small,  and  considerable  tuberculated  lung  surrounds  them,  the 
sound,  upon  percussion,  is  still  dull. 


DISEASES  OF  THE  CHEST. 


265 


If  the  cavity  be  large,  and  near  the  surface,  there  is  occasionally  a 
tympanitic  sound  with  musical  tone. 

Sometimes  a sound  is  heard  like  striking  a cracked  pot. 

Gurgling;  cavernous  rattle;  cavernous  breathing;  amphoric  breath- 
ing; now  and  then,  metallic  tinkling;  pectoriloquy;  cavernous  cough. 

General  Symptoms.  — Great  loss  of  flesh,  and  weakness  ; diarrhoea 
and  night-sweats ; swelling  of  the  feet  and  legs ; sore  mouth ; and 
raising  of  matter  with  specks  of  tubercle  in  it  like  crumbs  of  cheese. 

Observations.  — The  gurgling  rattle  is  caused  by  air  displacing 
liquids,  and  the  formation  and  bursting  of  bubbles.  It  resembles  the 
sound  produced  by  blowing  through  a tube  immersed  in  soap-suds. 

Cavernous  breathing  is  nothing  more  nor  less  than  the  sound  pro- 
duced by  air,  breathed  in  and  out,  entering  and  retiring  from  a 
cavity.  The  air  appears,  sometimes,  to  one  listening  with  the  stetho- 
scope, as  if  it  were  sucked  into  his  ear  during  inspiration,  and  blown 
back  again  during  expiration. 

Amphoric  respiration  is  simply  an  augmentation  of  cavernous 
breathing,  and  results,  of  course,  from  an  increase  of  size  in  the 
cavity. 

In  pectoriloquy,  words  uttered  by  the  patient  seem  to  pass  through 
the  stethoscope  into  the  ear  of  the  listener.  The  cavity  should  be 
empty,  moderate  in  size,  and  have  dense  walls,  in  order  to  furnish 
the  best  specimen  of  this  sound. 

Air  suddenly  driven  backward  through  the  windpipe,  and  out  of 
the  mouth  and  nose,  by  smart  raps  upon  the  chest  over  a cavity, 
gives  the  sound  of  the  cracked  pot.  It  is  best  heard  when  the  pa- 
tient’s mouth  is  partly  open.  The  same  sound  is  produced,  on  the 
same  principle,  by  locking  the  Angers  of  the  two  hands,  and  joining 
the  palms,  so  as  to  leave  a small  space  or  cavity  between  them,  and 
then  expelling  the  air  from  that  cavity,  by  gently  striking  the  back 
of  one  hand  upon  the  knee. 

Causes  of  Consumption.  — The  human  constitution,  as  shown  by 
Liebig,  in  his  profound  work  on  Animal  Chemistry,  is  governed  by 
two  forces,  the  nervous  and  the  vegetative.  The  former  disposes  the 
particles  composing  the  body  to  a state  of  motion ; the  latter  inclines 
them  to  a position  of  rest. 

In  vegetative  life  there  is  motion  in  one  direction  only,  so  to  speak; 
that  is,  motion  which  tends  to  the  opposite  of  motion,  namely,  rest. 
In  vegetables,  whose  life  is  wholly  under  this  power,  there  is  no  waste; 
for  here,  all  ultimate  particles,  having  once  taken  a place  of  rest, 
remain  undisturbed.  In  a tree,  a layer  of  matter  once  deposited, 
always  remains.  Hence  there  is  growth  as  long  as  the  tree  lives. 
There  is  no  power  to  break  up  and  destroy. 

But  in  the  animal  body  there  is  motion  in  two  directions,  or  a 
circuit  of  motion.  Particles  which  under  the  vegetative  force  have 
been  put  to  rest,  are  perpetually  being  displaced  by  the  nervous  energy, 


266 


DISEASES  OF  THE  CHEST. 


and  reduced  to  unorganized  amorphous  compounds,  to  be  burned  in 
warming  the  system,  or  cast  out  by  the  several  excretory  processes. 

So  constant  is  the  action  of  these  two  forces,  that  John  Hunter 
compared  the  human  system  to  a whirlpool,  into  which  the  particles 
of  matter  are  perpetually  poured,  under  the  influence  of  the  vegeta- 
tive power,  and  out  of  which  they  are  as  constantly  whirled  by  the 
nervous  force. 

By  a little  reflection  upon  these  antagonisms,  the  reader  will  see 
that  it  is  just  when  the  vegetative  force  transcends  the  nervous,  that 
the  body  increases  in  weight,  and  acquires  that  state  in  which  the 
blood  corpuscles  abound,  and  the  tendency,  if  to  disease  at  all,  is  to 
that  of  the  inflammatory  kind.  It  is  the  tonic  condition  of  the  sys- 
tem. Nutrition  is  more  rapid  than  destruction.  New  particles  are 
laid  down  faster  than  old  ones  are  taken  up.  The  body  grows. 

On  the  other  hand,  when  the  nervous  force  overmasters  the  vegeta- 
tive, when  the  outward  or  centrifugal  motion  of  the  whirlpool  prevails, 
then  it  is  that  the  body  is  attenuated,  the  blood  thinned  and  made 
serous,  and  the  consumptive  or  atonic  condition  is  established.  Now., 
there  is  too  much  motion.  The  nutritive  particles,  instead  of  tending 
to  a state  of  deposit  for  the  re-supply  of  waste  matter,  become  fugi- 
tive in  their  habits,  perpetually  fleeing,  like  convicts  escaped  from 
prison.  Introduce  this  power,  in  excess,  into  the  vegetable  kingdom, 
and  the  matter  deposited  upon  the  tree,  instead  of  remaining  to  swell 
its  bulk,  would  be  driven  off  by  the  nervous  force ; and  the  tree,  in- 
stead of  growing,  would  be  annually  lessened,  become  sickly,  and  die 
of  consumption. 

In  Tubercular  Consumption,  the  system  is  like  a field  deluged  by 
a flood ; nothing  can  take  root.  The  repeated  shocks  of  the  nervous 
battery  sent  to  the  absorbents  so  quicken  them  in  their  work  of  re- 
moving waste  matter,  that  they  dislodge  much  which  is  not  yet  worn 
out,  and  assist  in  casting  out  of  the  system  not  a little  designed  to  be 
used  in  its  renewal.  A healthy  deposit  is  thus  prevented,  and  nutri- 
tion is  at  an  end.  The  nutritive  arteries,  those  little  builders  of  the 
human  frame,  are  overmastered  by  the  stimulated  lymphatics ; the 
constructive  material  is  wrested  from  them,  and  borne  beyond  their 
reach,  and  the  body  wastes  from  want  of  nourishment.  The  blood 
becomes  thin  and  watery ; and  from  the  increased  serous  portion, 
chiefly  albumen,  are  deposited  upon  the  lungs  and  other  tissues  the 
albuminous  tumors  called  tubercles. 

Here  is  found  the  cause  of  that  peculiar  smallness  of  bone  and 
muscle,  and  thinness  and  tallness  of  person,  so  peculiar  to  consump- 
tives. The  absorbents,  under  the  power  of  a very  active  nervous 
system,  take  down  “ the  house  we  live  in  ” faster  than  the  nutritive 
arteries,  confused  liy  the  motion  around  them,  can  effect  its  recon- 
struction. It  is  simply  an  unbalancing  of  the  antagonistic  forces, 
which  build  and  pull  down  our  earthly  tenement.  The  men  that  de- 
molish are  more  numerous  and  better  fed  than  the  artisan  builders 


DISEASES  OF  THE  CHEST. 


267 


It  is  this  destnictively  nervous  force  which  gives  to  consumptive 
persons  their  proverbial  mental  activity;  which  causes  them  often  to 
dazzle  the  world  with  the  splendor  of  their  gifts,  and  to  bless  their 
friends  with  the  warmth  of  their  affections.  They  are  usually  the 
choice  spirits,  the  idols  of  their  relatives,  and  the  favorites  of  the  com- 
munity in  which  they  live.  Their  mental  movements,  and  the  exer- 
cise of  their  affections,  are  characterized  by  brilliancy  and  warmth. 
Of  all  persons,  they  are  best  fitted  to  enjoy  life,  and  to  impart  happi- 
ness. Loving  all,  they  are  by  all  loved  in  return.  They  are  speci- 
mens of  partially  etherealized  humanity,  stepping  lightly  across  the 
earth,  to  whom  friends  passionately  stretch  out  their  arms,  and  em- 
brace — tneir  shadows ! 

These  views  will  appear  the  more  reasonable,  if  we  consider  that 
in  children  the  vegetative  power  is  very  active,  while  the  nervous 
energy  is  comparatively  weak.  The  preponderance  of  the  former 
over  the  latter  causes  the  rapid  growth  of  children.  The  little  arterial 
builders  work  faster  than  the  lymphatic  demolishers.  This  explains 
why  so  few  children  die  of  consumption. 

But  from  the  age  of  seventeen  to  thirty-five,  when  the  vegetative 
power  is  losing  something  of  its  extraordinary  activity,  and  the  nerv- 
ous force  is  showing  its  highest  capabilities,  — then  it  is,  as  this 
theory  indicates,  that  tubercular  consumption  does  its  dreadful  work, 
— then,  that  the  outward  world  of  this  physiological  Maelstrom  casts 
upon  the  shores  of  mortality  so  many  thinned,  exhausted,  and  lifeless 
human  forms.  More  than  three-fourths  of  all  who  sink  under  this 
disorder  die  between  the  ages  just  named.  The  brain,  between  these 
points  of  time,  acquires  its  full  size  and  force. 

This  disease  prevails  most,  too,  in  those  countries  where  an  enlight- 
«ned  civilization  gives  to  the  nervous  system  its  fullest  development, 
as  in  Great  Britain,  France,  and  the  United  States,  and  in  those 
where  the  nutritive  process  is  most  retarded  by  a relaxing  climate  ; 
and  it  is  scarcely  known  among  those  people  who  are  but  little  en- 
hghtened  and  have  small  brains,  and  among  those  who  live  in  high 
and  invigorating  latitudes.  As  the  most  enlightened,  however,  are 
generally  found  in  temperate  climates,  and  those  with  the  least  culti- 
vated brains  in  low  latitudes,  the  rule  is  not  perfectly  explained  by 
facts ; yet  it  shows  itself  sufficiently  to  establish  its  validity,  and  to 
afford  another  proof  of  my  theory. 

Bronchial  Consumption. 

The  persons  exposed  to  bronchial  consumption  are  generally  of  an 
opposite  habit  to  those  described  above,  — having  the  nervous  force, 
in  health,  well  subordinated  to  the  vegetative,  the  assimilation  good, 
and  the  blood  well  supplied  with  red  globules.  They  have  usually  a 
full  habit  and  an  active  circulation.  The  absorbents,  and  other  ves- 
sels in  the  lungs,  working  in  the  midst  of  a large  amount  of  caloric 


268 


DISEASES  OF  THE  CHEST. 


evolved  by  an  energetic  respiration,  often  take  cold,  which  brings  on 
lung-fever  and  pleurisy,  and  these  lay  the  foundation  for  the  ultimate 
destruction  of  the  lungs.  For  the  same  reason,  the  skin  of  this  class 
of  persons  becomes  diseased,  and  more  often  the  inner  skin,  or  mu- 
cous membrane,  and  most  often  that  portion  of  mucous  membrane 
which  goes  down  into  the  lungs  and  lines  the  air-tubes.  It  is  inflam- 
mation of  this  which  constitutes  bronchitis,  and  which  lays  the  foun- 
dation for  true  bronchial  consumption. 

As  that  class  of  persons  who  are  exposed  to  the  tubercular  form  of 
the  disease  suffer  a general  loss  of  carburetted  hydrogen  in  its  several 
forms,  colliquative  diarrhoea,  sweats,  increased  breathing,  and  all  con- 
ditions that  carry  fat  out  of  the  system,  so  those  who  suffer  from 
attacks  of  the  bronchial  type  of  the  disorder  are  generally  afflicted 
with  the  opposite  condition.  They  have  too  much  carbon. 

It  is  well  ascertained  that  carburetted  hydrogen,  accumulated  in 
the  system,  acts  as  a poison.  And  that  class  of  bilious  persons  who 
are  subject  to  this  disease  often  have  their  excretions  badly  performed. 
For  this  reason,  carbonaceous  compounds  accumulate  in  the  system, 
and  give  rise  to  the  symptoms  of  morbid  poison  circulating  in  the 
blood.  This  led  Dr.  Madden  to  suspect  the  presence  of  such  poison 
in  the  blood  of  all  consumptive  persons.  He  saw  the  evidence  of  it 
in  numerous  cases,  and  not  distinguishing  the  one  class  from  the 
other,  he  inferred  its  presence  in  all. 

Constitutional  Difference. 

The  constitutional  difference  between  the  two  forms  of  consump- 
tion appears  to  be  this  : the  tubercular  type  is  usually  attended,  in  its 
origin,  by  a tolerably  good  state  of  the  digestive  function,  in  connec- 
tion with  bad  assimilation ; wliile  the  bronchial  form  generally  has 
its  foundation  laid  in  connection  with  bad  digestion,  accompanied 
with  healthful  assimilation.  In  the  former  case,  the  food  is  well  di- 
gested, the  pabulum  is  properly  prepared,  but  the  nutritive  arteries  do 
not  use  it  for  renewing  the  tissues.  In  the  latter  case,  the  digestion 
is  bad,  the  pabulum  poorly  elaborated ; but  the  re-constructive  vessels, 
under  the  control  of  a well-developed  system  of  organic  nerves,  use 
it  to  the  best  advantage.  In  the  one  case  there  are  good  hrick-makers, 
and  lazy  brick-Zayers  / in  the  other,  the  reverse. 

It  happens,  however,  that  before  the  fatal  close  of  the  disease,  tu- 
bercular patients  usually  become  afflicted,  more  or  less,  with  bad 
digestion,  and  bronchial  patients  with  defective  assimilation ; so  that, 
in  the  end,  they  present  us  with  much  the  same  class  of  symptoms. 
Starting  from  opposite  poles  in  life’s  celestial  sphere,  they  meet  at 
the  culminating  point  of  death,  and  disappear  under  identical  aspects 
of  the  heavens. 


DISEASES  OF  THE  CHEST. 


269 


Exciting  Causes  of  Tubercular  Consumption. 

The  preponderance  of  the  nervous  force  being  the  state  which  pre- 
disposes  to  disease,  whatever  unduly  excites  the  nervous  energy  in- 
vites an  attack. 

These  causes  relate,  mostly,  to  the  prolonged  exercise  of  the  intellect^ 
the  passions^  and  the  sentiments. 

Few  are  aware  of  the  mischief  done  by  excessive  stimulation  of 
the  mind  during  the  most  active  period  of  life,  — especially  if  the 
muscular  system  be  left  half  developed.  Here  is  where  ambitious 
students  commit  great  errors. 

The  constant  plying  of  the  mental  powers,  in  the  present  modes  of 
educating  children,  leads  to  a dreadful  abridgment  of  human  life. 
Better  to  train  the  bodily  powers  first,  and  let  the  mental  culture 
come  in  later  time.  He  who  would  build  a lasting  structure  must 
lay  a solid  foundation. 

The  age  in  which  we  live  abounds  in  the  causes  of  excitement. 
The  world  is  trembling  with  excess  of  mental  life.  The  pine  trees 
burned  by  the  steam-engine  are  scarcely  more  numerous  than  the 
human  constitutions  consumed  by  the  train  of  thought  it  has  set  on 
fire. 

Nor  are  the  passions  and  sentiments  less  exercised,  or  less  destruc- 
tive. 

Briefly,  the  causes  of  consumption  embrace  all  those  things  which 
bring  a destructive  force  against  the  digestive  and  assimilative  func- 
tions, as  insufficient  and  improper  food,  debaucheries,  night-watches, 
sedentary  habits,  anxiety  of  mind,  etc. ; and  those  which  act  injuri- 
ously upon  the  breathing  organs,  as  impure  air,  inflammation  of  the 
lungs,  pleurisy,  measles,  hooping  cough,  etc. ; and  such  as  disturb  the 
sweating  process,  as  insufficient  clothing,  sudden  changes  of  temper- 
ature, sleeping  in  damp  sheets,  etc.  These  exalt  the  nervous  force, 
or  depress  the  vegetative,  or  inflame  the  mucous  lining  of  the  air- 
tubes,  or  the  substance  of  the  lungs,  or  the  membranous  sack  which 
encloses  them,  so  as  to  induce  one  form  or  other  of  consumption  on 
the  principles  I have  explained. 

The  immediate  cause  of  consumption  we  know,  now-a-days,  to  he 
due  to  a deposit  of  tubercles  either  in  the  neighborhood  of  the  vocal 
cords,  the  upper  parts  of  the  lungs,  or,  not  infrequently,  at  the  bases 
of  the  same.  These  tubercles  contain  a germ  called  the  Tubercle 
Bacillus.^  which  can  only  be  seen  with  a high  power  microscope, 
and  then  only  after  being  stained  with  certain  aniline  colors  which 
they  absorb.  These  little  germs  are  of  the  rod-shaped  variety  of 
bacilli,  and  appear  under  the  microscope  as  little  straight  lines  or 
rods  about  inch  in  length.  Their  presence  in  the  sputum  of  a 
person  means  tuberculosis  of  some  part  of  the  air-passages ; when 
they  are  associated  with  the  presence  of  yellowish  fibres  (seen  under 
the  microscope)  they  are  a proof  of  the  deposit  being  in  the  lungs 


270 


DISEASES  OF  THE  CHEST, 


proper.  The  examination  of  one’s  sputum,  therefore,  in  the  early 
part  of  any  prolonged  and  suspicious  cough,  becomes  an  absolute  ne- 
cessity, since  thereby  one  is  made  aware,  in  the  earliest  stages,  of 
this  dreadful  disease,  and  an  opportunity  offered  of  attacking  it  at  once 
in  its  incipiency.  This  modern  discovery  has  given  rise  to  much 
experimentation  in  treatment  with  the  aim  in  view  of  killing  out  the 
germ.  Robert  Koch  of  Berlin  announced  to  the  world,  a short  time 
ago,  that  he  had  discovered  an  agent,  which  he  called  Tuberculin, 
that  would  eradicate  these  death-producing  germs,  but  time  has 
shown  his  efforts  to  be  unsuccessful  as  yet,  although  promising  of 
great  results  in  the  future.  These  germs  are  contagious  in  character, 
so  that  v/e  now  can  explain  why  many  contract  consumption  in  whose 
ancestral  blood  there  never  existed  any  tubercular  taint. 

We  know  that  husband  may  impart  the  disease  to  wife  and  mother 
to  daughter  if  only  the  system  is  in  a receptive  state  to^offer  a lodg- 
ment to  the  germs.  These  tiny  but  most  enduring  bacilli  retain 
their  life  for  an  indefinite  time  in  the  midst  of  dust  and  other  dried 
secretions,  so  that  a practical  point  is  that  all  persons  suffering  from 
tuberculous  diseases  should  be  exceedingly  careful  where  they  spit 
and  with  whohi  they  sleep.  To  raise  the  sputum  into  small  paper 
cups  wliich  may  be  burned  is  a common  and  very  prudent  custom. 

This  discovery,  while  not  disproving  the  old  theory  of  heredity, 
nevertheless  explains  many  a case  of  acquired  Phthisis,  and  clears  up 
many  an  old-fashioned  theory. 

These  are  indisputable  facts  from  which  the  medical  profession  at 
present  hope  to  derive  practical  benefit  by  the  discovery  of  some 
germicide  which  may  be  applicable  and  safe  for  internal  administra- 
tion. 

Can  Consumption  be  Cured  ? — In  many  cases  it  can.  It  maybe 
cured,  first,  by  the  absorption  of  the  tubercles.  The  celebrated  John 
Hunter  shows,  in  his  work  on  the  blood,  that  the  absorbent  vessels 
have  a sort  of  elective  affinity,  hj  which,  they  take  up  and  remove  “all 
adventitious  new  matter,  as  tumors”  (tubercles  are  albuminous  tu- 
mors), more  easily  “ than  those  parts  which  were  originally  formed.’* 
Were  this  not  so,  an  activity  in  these  vessels  equal  to  the  removal  of 
tubercles  would  cause  them  to  waste  all  the  tissues,  and  aggravate 
rather  than  cure  consumption.  Probably  this  does  occur  where 
proper  hygienic  means  are  not  used  to  quicken  the  excretions.  This 
hygienic  treatment,  to  be  spoken  of  hereafter,  is  not  generally  em- 
ployed, — certainly  not  as  effectually  as  it  should  be.  Here  is  the 
source  of  Laennec’s  fatal  remark,  so  often  quoted  and  so  widely  en- 
dorsed, that  nature’s  efforts  towards  effecting  a cure  are  injurious, 
and  those  of  art  are  useless.”  Laennec’s  position  cannot  be  true,  if 
Hunter’s  statement  is  correct.  If  the  absorbents,  by  an  elective  in- 
stinct, take  up  adventitious  matter  rather  than  the  natural  tissues, 
then  the  reason  why  they  reverse  this  rule  in  consumption  is,  that  by 
a weakened  state  of  the  constitution,  the  ultimate  particles  are  not 


DISEASES  OF  THE  CHEST. 


271 


well  put  together^  and  are  more  easily  taken  apart  than  those  of  the 
adventitious  tubercular  tumors ; and  if  we  would  restore  these  vessels 
to  their  natural  activity,  we  must  improve  assimilation,  and  knit  the 
unloving  molecules  into  a firmer  brotherhood.  We  must  make  the 
fiesh  hard,  so  that  the  absorbents  cannot  pick  it  to  pieces.  Do  this, 
and  “nature’s  efforts  to  effect  a cure”  will  not  “be  injurious.” 

A second  form  of  cure  is  the  reestablishment  of  the  assimilative 
function,  the  building  up  of  the  general  health,  the  arresting  of  the 
tubercular  deposit,  the  reducing  of  tubercles  already  formed  to  an 
indolent  state  ; and  then,  by  a strict  observance  of  the  laws  of  health, 
keeping  them  in  that  condition  through  life. 

A third  mode  of  cure  is  the  healing  of  the  cavities  after  the  tuber- 
cles have  softened,  broken  down,  and  been  expelled  in  the  form  of 
expectoration. 

A fourth  method  of  cure  is  a change  of  tubercles  to  calcareous 
matter.  These  calcareous  tubercles,  Laennec  says,  “are  consequent 
to  tuberculous  affections  that  have  heen  cured”  And  Andral,  at  one 
time,  hoped  to  learn  how  to  effect  cures  by  changing  tubercles  to 
“ the  calcareous  phosphate.” 

I have  had  several  cases  of  cure  by  this  last  method,  and  have 
quite  a collection  of  calcareous  substances  which  my  patients  have 
coughed  up,  — one  of  which  was  raised  in  my  presence  by  a lady 
who  was  a few  years  before  in  hopeless  consumption,  but  is  now  in 
good  health. 

Treatment.  — This  should  be  of  two  kinds,  local  and  general. 

The  local  treatment  of  consumption  is  by  the  inhalation  of  vapors 
and  powders  into  the  lungs.  It  has  been  practised,  more  or  less,  by 
individuals,  for  many  years,  particularly  in  Europe ; but  for  some 
unaccountable  reason,  the  profession  generally  have  never  used  it, 
and  do  not  know  much  about  it.  I had  the  honor,  some  years  agq 
to  bring  it  freshly  before  the  American  public,  in  some  articles  writ- 
ten for  popular  reading,  since  which  time  it  has  been  rapidly  gaining 
public  confidence,  and  is  now  attracting  much  attention.  Conveying 
the  remedy  directly  to  the  diseased  parts,  it  strikes  the  common- 
sense  mind  as  eminently  reasonable  and  necessary. 

I shall  speak  of  inhalation,  therefore,  very  earnestly,  not  as  a 
palliative  of  consumption  only,  but  as  far  more,  as  a remedy.  After 
long  and  patient  use,  my  experience  allows  me  to  say,  that  I know 
it,  in  many  cases,  to  be  such ; and  knowing  this,  I should  be  criminal 
not  to  press  it  upon  the  public ; for  it  is  the  great  multitude  of 
sufferers,  pressing  fast  through  the  gate  of  death,  who  need  to  hear 
words  of  hope. 

Consumption  a General  Disease.  — It  is  not  denied  that  con- 
sumption is  a general  disease,  needing  constitutional  treatment ; but 
it  has  also  a local  development  in  the  lungs,  first  in  the  form  of  al- 
buminous tumors,  called  tubercles,  and  then,  after  the  softening. 


272 


DISEASES  OF  THE  CHEST. 


breaking  down,  and  discharge  of  these,  in  the  more  formidable  shape 
of  ulcerous  cavities,  which,  beginning  at  the  summit,  devour  the 
lungs  down  to  the  base.  Can  it  be  reasonable  to  apply  no  remedy 
directly  to  this  local  disease?  Not  so  does  our  profession  deal  with 
other  local  diseases.  To  an  inflamed  skin  we  apply  poultices,  cold 
compresses,  solutions  of  acetate  of  lead,  nitrate  of  silver,  etc. ; to 
leprous  or  scaly  affections,  sulphuret  of  potash,  bichloride  of  mer- 
cury, zinc  ointment,  nitrate  of  mercury  ointment,  sulphur,  creosote, 
etc. ; to  weak  and  inflamed  eyes,  sulphate  of  copper,  sulphate  of 
zinc,  nitrate  of  silver,  and  opium ; to  chronic  ulcers  upon  the  skin, 
tannin,  pulverized  rhubarb,  opium,  or  cinchona ; and  to  an  inflamed 
throat,  nitrate  of  silver  and  other  articles.  These  are  but  specimens 
of  the  thousand  cases  in  which  we  use  local  remedies.  Why,  then, 
when  the  mucous  membrane,  which  lines  the  air  tubes,  becomes  in- 
flamed through  all  its  branches,  should  we  neglect,  by  the  inhalation 
of  medicated  vapor,  to  apply  a remedy  directly  upon  the  whole  in- 
flamed surface  ? Why,  when  tubercular  matter  is  beginning  to  be 
deposited  upon  the  surface  of  the  air  cells,  and  of  the  small  bronchial 
tubes,  should  not  the  vapor  go  right  to  those  parts,  and  cause,  as  it 
would,  the  immediate  expulsion  of  this  offending  and  dangerous 
matter  ? 

Uneducated  common  sense  sees  the  reasonableness  of  these  sug- 
gestions at  a glance.  Many  a person,  with  pulmonary  disease,  dies 
of  suffocation,  not  because  there  is  not  muscular  strength  to  expel 
the  matter  which  is  strangling  him,  but  because  the  lungs  below  the 
large  pellets  of  mucus,  which  plug  up  the  bronchial  tubes,  cannot  be 
inflated,  and  have  therefore  no  means  of  driving  out  the  offending 
substance.  Yet  a proper  medicated  vapor,  drawn  in  with  the  breath, 
would  either  dissolve  the  mucus,  or  rouse  up  the  expiring  membrane 
to  cast  it  off. 

If  the  reader  were  to  place  one  end  of  a stethoscope  directly  over 
the  disease  upon  the  breast  of  a person  in  the  third  stage  of  consump- 
tion, and  should  then  ask  him  to  talk,  the  words  spoken  would  seem 
to  rise  up  through  the  instrument,  and  enter,  well  articulated,  into 
his  ear.  This,  in  technical  language,  is  called  joectonYog'wy, — a word 
signifying  chest-talking.  It  implies  a cavity  in  the  lung.  If  now  the 
patient  be  asked  to  cough,  a gurgling  and  splashing  sound  will  be 
heard.  This  denotes  that  the  cavity  is  partly  fiUed  with  fluid,  which 
is  dashed  about  by  the  air  explosively  driven  through  it  by  the  portion 
of  lung  below.  Here  we  have  an  excavated  ulcer,  with  all  its  filthy 
contents,  composed  of  pus,  mucus,  serum,  and  dissolved  tubercles, 
lying  in  it  day  and  night  to  aggravate  its  unhealthy  condition.  What 
more  reasonable,  what  more  necessary,  than  that  a soothing,  alterar 
tive,  or  astringent  vapor  should  be  drawn  into  this  cavity,  to  cause 
its  sides  to  heal,  and  its  absorbents  to  remove  this  fluid  ? A surgeon 
who  should  permit  an  ulcer  upon  the  surface  of  the  body  to  remain 
in  that  condition  without  a local  dressing  would  be  deemed  unfit  to 
practise  his  profession. 


DISEASES  OF  THE  CHEST. 


273 


Both  in  tubercular  disease  and  in  simple  bronchitis,  the  bronchial 
tubes  almost  always  suffer  some  physical  change.  The  mucous 
membrane  lining  these  tubes  is  generally  softened.  At  other  times 
the  tubes  become  enlarged  through  their  whole  length,  so  that  many 
of  them,  from  the  size  of  a quill,  reach  the  bigness  of  the  finger  of  a 
glove.  In  still  other  cases,  the  straining  produced  by  coughing 
causes  a tube  to  belly  out  at  some  point,  forming  a sack,  which  is 
generally  filled  with  mucus  or  purulent  matter.  At  still  other  times, 
a tubercle  will  press  against  a tube  so  as  to  flatten  it  and  convert  it 
into  a musical  instrument,  the  air,  as  it  is  drawn  laboriously  through, 
producing  a high  or  low  note,  according  to  the  size  of  the  pipe. 
These  physical  changes  are  all  produced  by  causes  which  the  inhala- 
tion of  a suitable  vapor,  at  the  proper  time,  would  almost  infallibly 
remove.  How  strange  that  this  remedy,  — so  simple,  so  effectual, 
so  easily  comprehended,  — should  have  been  so  little  used ! 

Right  at  this  vital  point  in  the  lungs,  where  the  blood  runs  in  a 
ceaseless  current,  — where  the  whole  of  it  goes  every  two  minutes  to 
renew  its  vitality  by  contact  with  atmospheric  air,  — we  have,  in 
thousands  of  cases  daily  occurring,  inflammation  with  roughening  or 
softening  of  membrane,  with  its  consequent  harsh  breathing ; we  have 
mucus,  tough  or  glairy,  to  impede  and  interrupt  respiration ; we  have 
tubercles  in  the  hard  or  soft  state,  adding  to  the  general  embarrass- 
ment, and  not  only  lessening  the  vitality  of  the  blood,  but  disturbing 
all  the  sympathies  of  the  system ; — and  yet  the  practice  has  been, 
and  is,  to  attack  these  central  disturbers  of  life  only  through  the  cir- 
cuitous path  of  the  stomach,  lacteals,  etc. 

I have  investigated  faithfully  the  effects  of  the  various  substances 
proposed  for  inhalation  by  European  physicians,  and  have  explored  a 
wide  field  of  new  remedies,  not  before  used,  several  of  which  have 
proved  to  have  qualities  of  great  remedial  power. 

The  chief  remedies  I employ  for  inhalation  are  the  following . 

Alterative  Inhalant,  composed  of  iodine,  six  grains ; iodide  of 
potassium,  twelve  grains ; tincture  of  ipecac,  one  ounoO ; tincture  of 
balsam  of  tolu,  six  drams ; ethereal  tincture  of  conium,  one  and  a half 
drams ; alcohol,  half  a pint.  These  are  to  be  mixed.  The  dose  is 
one  to  two  teaspoonfuls,  to  be  inhaled  ten  or  fifteen  minutes,  in 
about  a gill  of  hot  water. 

The  ethereal  tincture  of  conium  is  made  by  keeping  a dram  of 
powdered  conium  in  one  ounce  of  sulphuric  ether  a week. 

The  above  inhalant  is  used  in  the  tubercular  forms  of  consump- 
tion, particularly  that  of  the  scrofulous  kind,  and  in  many  cases  of 
bronchitis. 

Expectorant  Inhalant.  — Take  pleurisy  root,  half  an  ounce ; 
squill,  one  ounce ; ipecac,  two  drams ; black  cohosh,  two  ounces : 
queen’s  root,  one  ounce  and  a half ; American  hellebore,  two  drams ; 
diluted  alcohol,  one  pint.  Grind  the  roots,  etc.,  and  add  the  alcohol. 


274 


DISEASES  OF  THE  CHEST. 


Irdt  the  whole  stand  one  week,  shaking  or  stirring  daily.  Draw  off 
and  filter  through  paper.  Two  teaspoonfuls  make  a dose,  to  be  in- 
haled same  as  preceding. 

This  is  to  he  used  when  the  cough  is  hard  and  dry,  and  the  expec- 
toration difficult.  It  makes  the  raising  easy,  lessening  the  soreness 
of  the  chest,  and  the  harsliness  of  the  cough. 

Soothing,  Febrifuge  Inhalant.  — Take  belladonna  leaves,  half  an 
ounce;  black  cohosh,  two  ounces;  American  hellebore,  half  an  ounce; 
poke-root,  two  drams ; aconite  root,  one  ounce ; diluted  alcohol,  one 
pint.  Grind  the  roots,  etc.,  add  the  alcohol.  Let  the  whole  stand 
one  week,  stirring  daily.  Pour  off  and  filter  through  paper.  Dose, 
one  to  two  teaspoonfuls,  to  be  inhaled  as  the  preceding. 

This  is  excellent  in  all  cases  where  the  skin  is  hot,  the  pulse 
quick,  the  tongue  and  mouth  parched,  the  chest  sore,  and  the  system 
suffering  during  the  whole  or  a part  of  each  day,  from  a general 
feverish  condition.  It  is  proper  in  all  the  forms  of  chest  disease. 

Astringent  Inhalant.  — Take  of  wild  indigo,  one  ounce;  catechu, 
half  an  ounce ; Peruvian  bark,  one  ounce ; golden  seal,  one  ounce ; 
diluted  alcohol,  one  pint.  Mix,  and  let  the  whole  stand  one  week, 
stirring  daily.  Drain  off,  and  filter  through  paper.  Add  two  drams 
of  creosote.  One  to  two  teaspoonfuls  to  be  inhaled  as  preceding. 

This  is  to  be  used  when  the  expectoration  is  profuse  and  easy,  un- 
attended by  fever,  either  in  the  latter  stages  of  chronic  bronchitis, 
when  the  mucous  membrane  of  the  tubes  is  in  a relaxed  condition, 
or,  in  the  third  stage  of  tubercular  disease,  for  the  purpose  of  con- 
stringing, cleansing,  strengthening,  and  healing. 

Antiseptic  Inhalant.  — Take  wild  indigo,  one  ounce;  belladonna 
leaves,  half  an  ounce ; diluted  alcohol,  one  pint.  Mix,  and  let  the 
whole  stand  one  week.  Pour  off,  and  filter  through  paper.  Then 
add  solution  of  chloride  of  soda  two  ounces.  Dose,  one  to  two  tea- 
spoonfuls, to  be  inhaled  as  the  preceding. 

This  is  used  in  cases  of  gangrene  of  the  lungs,  generally  distin- 
guished by  considerable  expectoration  having  a very  fetid  smell. 

Anti=Hemorrhagic  Inhalant.  — Take  witch-hazel  bark,  two 
ounces ; black  cohosh,  four  ounces.  Grind,  and  add  one  pint  of 
diluted  alcohol.  Let  the  mixture  stand  one  week,  stirring  daily. 
Pour  off,  and  filter  through  paper.  Add  to  this  two  drams  of  creo- 
sote. Dose,  one  to  tliree  teaspoonfuls,  to  be  inhaled  as  preceding. 

This  is  an  excellent  remedy  for  bleeding  from  the  lungs.  When 
there  is  a tendency  to  bleed,  it  should  be  used  for  a long  time.  It 
may  frequently  take  the  place  of  the  above  astringent  inhalant. 

For  immediate  relief  give  strong  solution  of  salt  water. 

Object  of  Inhalants.  — Being  vaporized  and  inhaled,  these  articles 
enter  every  air-cell  throughout  the  lungs.  Their  object  is  to  soothe 
and  mollify  inflamed  mucous  surfaces,  to  reduce  enlarged  bronchial 


DISEASES  OF  THE  CHEST. 


275 


glands  whiclx  press  upon  neighboring  parts  and  cause  bleeding,  to 
stimulate  the  absorbents  to  take  up  and  remove  tubercles,  to  dissolve 
tubercles  out  of  the  pulmonary  tissue,  to  cause  ulcerous  cavities  to 
expel  tbeir  mattery  contents,  and  to  stimulate  tbeir  sides  to  take  on 
a healing  process.  They  should  be  used  from  three  to  six  times  a 
day,  the  inhalation  continuing  from  ten  to  fifteen  minutes. 

Other  Inhalants.  — Great  numbers  of  other  articles  have  been 
used,  which  I have  not  space  to  describe.  I will  mention,  however, 
that  the  following  are  sometimes  employed  with  advantage : — 

For  an  Expectorant  Inhalant,  take  alcohol,  four  ounces ; tincture 
of  camphor,  half  an  ounce ; tincture  of  tolu,  two  drams ; naphtha, 
one  dram ; benzoic  acid,  thirty  grains ; oil  of  bitter  almonds,  four 
drops.  Mix. 

For  an  Anodyne  Inhalant,  take  alcohol,  four  ounces  ; naphtha,  one 
dram ; benzoic  acid,  thirty  grains ; chloroform,  twenty-five  drops ; 
tincture  of  henbane,  half  an  ounce.  Mix. 

For  an  Astringent  Inhalant,  take  alcohol,  four  ounces ; naphtha, 
one  dram ; benzoic  acid,  thirty  grains  ; chloroform,  one  dram ; tannin, 
eight  grains.  Mix. 

Mode  of  Inhaling.  — For  inhaling  these,  a sponge  is  fitted  into  a 
glass  cup,  to  which  a flexible  tube  is  attached.  A small  quantity  of 
the  mixture  is  poured  upon  the  sponge,  and  the  vapor  arising  is 
drawn  into  the  lungs  through  the  tube. 

To  the  expectorant  inhalant  may  be  added,  occasionally,  half  a 
dram  of  nitric  acid. 

These  latter  formulas  are  the  principal  ones  used  by  those  who 
practice  what  is  called  cold  inhalation. 

A very  common  mode  of  inhaling  volatile  remedies  is  by  saturat- 
ing a little  cotton,  contained  in  a wire  basket,  with  the  desired  oil  or 
fluid,  and  placing  it  over  the  mouth  and  nose.  It  is  to  be  worn 
throughout  the  day.  Oil  of  peppermint,  creosote,  menthol,  oil  of 
eucalyptus,  etc.,  etc.,  are  among  the  more  common  remedies  thus 
used. 

A good  inhaler  can  be  bought  of  any  dealer  in  surgical  instruments. 

Constitutional  Treatment.  — The  rapid  breathing  in  consump- 
tion creates  too  much  oxydation  of  the  blood,  — so  much,  that  the 
muscles,  especially  the  heart,  are  usually  of  a bright  red.  To  prevent 
the  patient  from  being  literally  burned  up  by  oxygen,  the  blood 
must  be  de-oxydated  as  fast  as  possible. 

While  there  is  too  much  of  oxygen,  there  is,  at  the  same  time,  a 
deficiency  of  carbon.  Hence  the  cold  hands  and  feet,  and  the  gen- 
eral inability  to  bear  frosty  weather.  The  little  nutritive  arteries,  in 
these  thin-blooded  persons,  stand  shivering  and  torpid  with  cold,  un- 
able to  perform  their  allotted  function  of  nutrition.  There  is  not 
fire  enough,  and  fuel  must  be  had  in  the  form  of  carbon.  Hence  one 
of  the  advantages  of  cod-liver  oil.  This  oil,  too,  as  carbon,  devours 


276 


DISEASES  OF  THE  CHEST. 


the  oxygen  of  the  blood,  and  prevents  its  destroying  the  patient. 
This  idea  also  explains  the  fact  mentioned  by  Bennet  and  others, 
that  in  their  post-mortems  they  found  the  evidences  of  healed  ulcers 
in  numerous  persons  who  had  been  spirit-drinkers  while  living.  And 
Liebig  helps  the  explanation  by  saying  that  alcohol,  taken  into  the 
system,  circulates  in  a free  state  in  the  blood,  and  devours  its  oxygen. 
To  which  I beg  to  add,  that  the  malaria  of  intermittent  and  bilious 
fever  districts,  has  been  pretty  satisfactorily  proved  to  be  an  instable 
organic  body,  consisting  of  sulphur,  carbon,  and  hydrogen,  all  of 
which  have  an  affinity  for  oxygen,  and  devour  it  in  the  system. 
Consumption  is  not  found  in  such  districts. 

As  I am  here  treating  of  the  chemical  effects  of  remedies  (and  to 
this  test  most  remedies  must  finally  come),  I will  mention  that  tar- 
trate of  antimony  and  potassa  arrests  the  circulation  in  the  pulmonary 
arteries^  — which  fact  gives  a complete  and  luminous  view  of  its 
power  to  prevent  oxidation.  But  I am  obliged  to  detract  from  its 
merits,  by  stating  that  it  also  retards  the  circulation  in  the  capillaries 
of  the  system  generally,  and  so  hinders  c?e-oxidation. 

Phosphorus.  — There  is  an  article  which  has  more  recently  pre- 
sented itself  to  the  notice  of  the  profession,  to  which  I wish  to  invite 
special  attention.  I refer  to  phosphorus.  This  agent,  for  a time, 
challenged  our  notice  in  the  shape  of  phosphate  of  lime  ; but  we  could 
never  feel  sure  that  this  article  was  dissolved  in  the  fluids  of  the 
body.  We  now  use,  and  with  far  more  marked  effect,  the  hypo- 
phosphites  of  lime,  soda,  potash,  and  iron.  These  are  used  in  the 
form  of  the  syrup  of  the  hypophosphites.  The  dose  is  a teaspoonful 
before  each  meal.  The  effect  unon  tubercular  disease  is  immediate 
and  gratifying. 

Need  of  Phosphorus.  — Cerebric  acid  contains  nitrogen  and  phos- 
phorus, and  is  the  peculiar  component  of  the  brain  and  nervous  sys- 
tem. By  combustion  and  the  changes  of  oxidation  in  the  brain,  the 
phosphorus  of  cerebric  acid  is  converted  into  phosphoric  acid ; so  that 
every  act  of  the  brain  produces  phosphoric  acid.  How  rapid,  then, 
must  be  the  consumption  of  the  phosphoric  element  of  the  cerebric 
acid,  in  that  highly  active  and  excitable  state  of  the  nervous  system 
which  I have  described  as  peculiar  to  consumption.  And  how  neces- 
sary, in  order  to  save  the  brain  from  destruction,  to  meet  this  increased 
demand  for  phosphorus,  by  introducing  it  into  the  system. 

Mulder  regards  the  fibrin  of  the  blood  as  the  carrier  of  oxygen;  and 
by  this  oxidation,  the  fibrin  becomes  converted  into  the  biuoxide  and 
trioxide  of  protein,  — its  phosphorus  and  sulphur  (for  it  contains 
both)  being  converted  into  phosphoric  and  sulphuric  acids.  Adding 
phosphorus  and  sulphur,  therefore,  as  medicinal  agents,  would  seem 
to  be  the  proper  way  to  supply  the  fibrin  with  materials  destructive 
of  its  freight  of  oxygen. 

It  is  well  known  that  the  salts  of  phosphoric  acid  are  essential  for 


DISEASES  OF  THE  CHEST. 


277 


the  formation  of  azotic  compounds,  — compounds  which  are  neces- 
sary to  sustain  animal  life.  It  should  be  remembered,  too,  as  collat- 
erally illustrating  this  fact,  that  the  tribasic  phosphates  of  potash,  soda, 
lime,  and  magnesia,  play  an  important  part  in  the  growth  and  perfec- 
tion of  plants.  They  are  always  found  in  the  seeds  of  the  cerelia,  and 
no  mature  grains  are  produced  where  phosphates  are  absent  from  the 
soil.  For  the  production  of  abundant  grain-crops,  it  is  necessary 
that  these  salts  should  exist  in  the  soil,  or  be  applied  to  it  in  manures. 

It  is  known,  moreover,  that  in  all  chronic  diseases  distinguished  by 
wasting  of  the  tissues,  a much  larger  quantity  of  phosphates  is  ex- 
creted by  the  kidneys  than  in  the  normal  state.  Hence  there  is  no 
healtliful  growth ; and  the  human  organism,  like  the  soil,  exhausted 
of  its  phosphates  by  successive  croppings,  brings  nothing  to  perfec- 
tion, and  needs  to  have  its  drained  salts  re-supplied. 

I cannot  but  call  attention  here  to  the  inorganic  substances  found 
in  healthy  human  blood.  According  to  very  careful  analyses,  by 
Schmidt : 


1000  parts  of  blood-corpuscles,  contain  : 


Chlorine 1.686 

Sulphuric  Acid 0.066 

Phosphoric  Acid 1.134 

Potassium 3.328 

Sodium 1.052 

Oxygen 0.667 

Phosphate  of  Lime 0.114 

Phosphate  of  Magnesia  ....  0.073 


1000  parts  of  liquor  sanguinis 
and  fibrin),  contain : 

Chlorine 

Sulhuric  Acid 

Phosphoric  Acid 

Potassium 

Sodium 

Oxygen  

Phosphate  of  Lime  .... 
Phosphate  of  Magnesia  . . . 


(serum 

, 3.664 
. 0.115 
, 0.191 
. 0.323 
. 3.341 
. 0.403 
. 0.311 
. 0.222 


Iron  is  omitted.  Now,  I venture  the  prediction,  that  out  of  these 
figures,  mainly,  in  connection  with  those  which  represent  the  consti- 
tuents of  the  saliva,  the  bile,  the  gastric  juice,  the  pancreatic  secretion, 
and  the  organic  compounds  of  the  blood  and  tissues,  are  to  be  evolved 
within  a few  years  a correct  and  partially  demonstrative  system  of 
medication.  In  consumption,  all  the  inorganic  bodies  represented  by 
the  above  figures,  with  the  exception  of  oxygen,  are  deficient  in  quan- 
tity. By  reflecting  upon  the  proportions  of  these  several  bodies,  par- 
ticularly upon  the  large  amount  of  chlorine  and  soda  in  the  plasma, 
and  of  potassium  in  the  corpuscles,  the  mind  can  hardly  fail  to  obtain 
useful  hints.  I have  not  hesitated  to  make  one  of  these  hints  the 
of  a very  free  use  of  alkalies,  — particularly  in  the  form  of 

Sugar  of  Milk.  — There  is  one  other  medicinal  article  which  I deem 
worthy  to  be  made  prominent,  and  to  be  placed  side  by  side  with  cod 
liver  oil  and  the  hypo-phosphites.  I refer  to  sugar  of  milk.  It  belongs 
to  that  class  of  non-nitrogenized  articles  which  Liebig  has  denomi- 
nated supporters  of  respiration.  Its  great  affinity  for  oxygen  is  well 
worthy  to  be  taken  into  the  account,  in  considering  its  value  in  con- 
sumption. So  great  is  this  attraction,  that,  with  ammonia  and  other 
alkalies,  it  has  the  power  of  reducing  some  of  the  metallic  oxides. 


ground 

bathing 


278 


DISEASES  OF  THE  CHEST. 


When  taken  into  the  stomach,  it  is  rapidly  absorbed  into  the  blood, 
which,  being  an  alkaline  fluid,  augments  its  great  de-oxidating  power 
to  a considerable  degree.  It  unites  rapidly  with  oxygen  after  enter- 
ing the  blood,  forming  carbonic  acid  and  water.  A part  of  it,  how- 
ever, does  not  enter  the  blood  in  an  uncompounded  state,  but  is 
changed  in  the  stomach  into  lactic  acid ; and  this,  in  the  blood,  be- 
comes an  alkaline  lactate.  But  the  portion  thus  changed  appears 
also  very  useful;  for  Lehmann  says:  “We  know  of  no  substance 
which  could  better  act  in  the  blood  as  food  for  the  respiration,  than 
the  alkaline  lactates.” 

Corroborative  of  these  views  is  the  fact  that  all  those  kinds  of 
milk,  such  as  goat’s,  ass’s,  etc.,  which  contain  the  largest  amount  of 
sugar  of  milk,  have  at  different  times,  and  in  various  countries,  ob- 
tained a reputation  for  curing  consumption.  Goat’s  whey,  in  which 
this  article  abounds,  and  from  winch  it  is  largely  manufactured,  has 
been  celebrated  for  its  virtues  in  this  line.  Ancel  speaks  of  it  as  an 
excellent  remedy ; and  Pereira  says,  “ Sugar  of  milk,  in  consumptive 
cases  and  chronic  diseases  of  the  digestive  organs,  is  a most  valuable 
aliment.” 

One  of  the  best  forms  of  taking  sugar  of  milk  is  that  of  a gruel, 
which  is  quite  palatable,  and  may  be  freely  eaten  by  consumptive 
persons. 

Creosote,  Guaicol,  etc.  — Modern  researches  having  proved  that 
eonsumption,  as  well  as  maHy  throat  and  other  diseases  are  propa- 
gated by  germs  or  bacilli,  as  explained  on  page  269,  medical  investi- 
gators have  for  a long  time  been  seeking  some  agent  that  would 
destroy  these  germs  without  at  the  same  time  injuriously  affecting 
the  human  system.  A few  years  ago  Dr.  Robert  Koch,  a celebrated 
German  scientist,  who  had  long  been  investigating  the  consumption, 
cholera,  and  other  microbes,  thought  he  had  discovered  a lymph  that 
would  destroy  or  at  least  counteract  the  consumption  bacillus ; but 
unfortunately  it  proved  a failure.  Creosote,  carbolic  acid,  guaicol 
and  similar  drugs  kill  the  germ  when  outside  the  body,  and  for  this 
reason  most  therapeutists  of  to-day  use  these  remedies  in  as  large  a 
quantity,  and  for  as  long  a time  as  the  system  will  tolerate.  At  all 
events,  whatever  may  be  the  outcome  of  thecustom  at  present  in 
vogue,  creosote  certainly  arrests  the  rapid  proliferation  of  germ-life 
in  the  lungs,  improves  the  appetite  and  digestion,  lowers  the  temper- 
ature, and  apparently  helps  the  patient.  The  only  offset  to  the  use 
of  this  class  of  remedies  lies  in  the  fact  that  one  eannot  thoroughly 
disinfect  the  blood  sufficiently  to  kill  these  germs  completely.  Creo- 
sote made  from  beechwood,  taken  in  three-drop  doses  with  a wine- 
glass of  milk,  after  food,  three  times  a day,  is  the  usual  form  of 
administration.  This  dose  should  gradually  be  increased  till  ten  and 
even  twenty  drops  are  taken  at  a time.  The  carbonate  of  creosote  is 
a more  elegant  and  perhaps  more  effective  form  of  the  drug.  This 
medicine  may  also  be  procured  in  the  form  of  capsules  and  pills. 


DISEASES  OF  THE  CHEST. 


279 


By  Dr.  Cyrus  Edison’s  recently  discovered  product  of  carbolic 
acid,  asepsin,  it  is  claimed  that  seventy  per  cent  of  consumptive 
cases  can  be  cured.  It  can  only  be  administered  as  a hypodermic 
injection,  however,  at  the  hands  of  an  experienced  practitioner. 

The  Cough.  — The  best  article  I have  ever  used  for  this  is  the 
“ Pulmonic  Cherry  Cordial.”  I was  five  years  in  compounding  this 
article  to  suit  me,  and  I believe  it  to  be  the  very  best  cough  prepa- 
ration ever  made.  Dose,  from  one  to  two  teaspoonfuls. 

Pulmonic  Cherry  Cordial. — Wild-cherry  bark,  ground,  10  pounds 
ipecac  root,  20  ounces ; bloodroot,  24  ounces ; squill  root,  bruised,  12 
ounces ; pulverized  liquorice  root,  5 ounces ; cochineal,  bruised,  2 
ounces;  anise  seed,  32  ounces;  fennel  seed,  8 ounces;  orange  peel, 
16  ounces  ; acetate  of  morphine,  12  drams  ; alcohol,  8 gallons  ; water, 
8 gallons  ; pulverized  white  sugar,  40  pounds ; sulphuric  acid,  1 
ounce. 

Directions  for  making.  — Grind  all  the  articles  to  a*  coarse  powder 
except  those  directed  to  be  bruised  or  pulverized,  and  put  them  all 
to  the  alcohol  except  the  wild-cherry  bark,  the  water,  the  sugar,  and 
the  sulphuric  acid.  Let  them  stand  one  week,  shaking  or  stirring 
thoroughly  twice  a day.  Then,  having  kept  the  wild-cherry  bark  two 
days  in  a covered  vessel,  with  water  enough  upon  it  to  wet  it  through, 
place  it  in  a percolator,  and  run  eight  gallons  of  water  through  it. 
Add  this  to  the  alcohol  and  other  ingredients.  Let  the  whole  stand 
tliree  days  longer,  stirring  as  before,  twice  a day.  Draw  off,  and  fil- 
ter through  paper.  Now  add  the  sugar,  and  lastly  the  sulphuric  acid. 
The  acid  is  intended  mainly  to  improve  the  color,  by  acting  chemi- 
cally upon  the  cochineal.  The  color  is  a fine  cherry  red,  tinged  with 
orange. 

I have  given  the  directions  for  making  sixteen  gallons  — this  being 
the  smallest  quantity  in  which  I make  it.  Any  person  ean  easily 
make  the  calculation  for  reducing  the  quantity.  The  assertion  pre- 
viously made  that  this  is  the  “ best  cough  preparation  ever  made,”  I 
see  no  cause  to  modify  in  the  smallest  degree.  Were  it  kept  in 
every  apothecary  shop,  and  were  physicians  to  prescribe  in  pul- 
monary complaints,  adding  a little  syrup  of  squills  or  wine  of  ipecac 
when  a more  expectorant  effect  is  wanted,  or  a little  morphine  if 
greater  narcotism  is  sought,  it  would  save  them  much  trouble  in  com- 
pounding cough  syrups,  and  give  them  much  more  satisfactory  re- 
sults. I have  compared  its  effect,  again  and  again,  with  the  best 
other  preparations  in  use,  and  I pledge  my  word  that  it  will  succeed 
in  twice  as  many  cases  as  any  other  compound  that  may  be  chosen. 
Let  physicians  try  it;  and  I will  be  responsible  for  ever  hair’s 
breadth  in  which  they  find  this  proportion  of  successful  results 
abridged. 

When  a more  quieting  effect  is  needed,  a little  morphine  may  be 
added  to  this  preparation  ; if  a more  expeetorant  influence  is  required, 
add  a few  drops  of  the  tincture  of  veratrum  viride.  For  the  great 


280 


DISEASES  OF  THE  CHEST. 


majority  of  cases,  it  will  be  found  to  be  right  without  any  addition. 
When  this  is  not  at  hand,  any  of  the  preparations  (108),  (112),  (109), 
(113),  (110),  etc.,  may  be  used.  Another  good  preparation  is  Dr. 
King’s  consumption  cure. 

Night  Sweats.  — The  very  best  preparation  for  these  sweats  is  a 
compound  of  the  oxide  of  zinc,  one  dram ; extract  of  conium,  half  a 
dram ; to  be  made  into  twenty  pills,  of  which  one  or  two  are  to  be 
taken  every  night.  The  sponge  bath  also  does  much  to  check  these 
sweats,  and  vinegar  baths  (369).  Atropia,  of  a grain  on  retiring, 
and  especially  Agaricin,  A grain,  will  cause  the  sweats  to  stop  abso- 
lutely. 

Diarrhoea.  — This  is  a most  exhausting  symptom  in  the  latter 
stages  of  consumption.  The  only  remedy  which  has  much  effect  in 
controlling  it  is  the  tris-nitrate  of  bismuth.  This  should  be  given  in 
doses  of  thirty  grains  immediately  after,  or  at  the  time  of  each  meal. 
These  doses  are  much  larger  than  used  to  be  given ; but  they  will 
do  no  harm.  Given  to  this  extent,  I find  the  bismuth  very  effectual. 

Iron. — This  preparation,  in  some  of  its  forms  (316),  (73),  (159), 
(102),  is  almost  always  needed  in  consumption.  If  the  scrofulous 
habit  be  strongly  marked,  give  syrup  of  iodide  of  iron,  in  thirty-drop 
doses,  three  times  a day.  It  should  be  taken  in  a glass  of  water.  To 
the  feeble  administer  Gude’s  pepto-mangan  in  teaspoonful  doses  three 
or  four  times  daily.  This  is  one  of  the  simplest  and  most  effica- 
cious forms  of  iron  we  have. 

External  Irritants. — These  are  needed  where  there  is  much  in- 
flammation and  soreness  of  the  chest.  Blisters  should  very  seldom 
be  used.  Croton  oil,  from  two  to  half  a dozen  drops,  rubbed  over 
the  sore  part,  generally  answers  very  well.  Sometimes  the  mustard 
paste,  applied  to  the  extent  of  producing  redness,  two  or  three  times 
a week,  is  sufficient.  Nitric  acid,  reduced  with  water  to  a strength 
a little  above  the  strongest  vinegar,  answers  a good  purpose  for 
keeping  up  an  irritation. 

Atmospheric  Inhalation. — It  has  been  said  by  Laennec  and  others, 
that  asthma  has  sometimes  the  effect  of  arresting  tubercular  consump- 
tion. Dr.  Ramadge  thought  this  was  effected  by  an  expansion  of 
the  vesicular  structure  of  the  lungs ; and  he  reasoned  that  the  same 
expansion,  by  mechanical  means,  would  secure  a similar  end.  To  ef- 
fect this,  he  made  his  patients  take  long  breaths  through  a tube  con- 
structed for  the  purpose. 

It  is  manifest  that  the  philosophy  of  atmospheric  inhalation  was 
not  understood  by  Dr.  Ramadge,  nor  has  it  been  by  any  of  his  fol- 
lowers in  this  country. 

Rokitansky  tffinks  the  tubercular  habit  depends  upon  the  excess 
of  fibrin  in  the  blood ; and  says  that  the  reason  of  consumption  being 
arrested  by  pregnancy  is,  that  this  condition  offers  a mechanical  ob- 


DISEASES  OF  THE  CHEST. 


281 


Stacie  to  the  transmission  of  blood  through  the  lungs,  — thus  pre- 
venting its  excessive  oxidation,  and  keeping  it  in  a venous  state. 
This  destroys  the  fibrinous  condition,  on  which  he  thinlrs  tuberculosis 
depends. 

Now  this  is  precisely  what  is  done  by  atmospheric  inhalation.  The 
trachea  divides,  on  its  entrance  into  the  lungs,  into  two  branches, 
which  again  divide  and  subdivide  until  the  tubes  become  smaller 
than  can  be  seen,  each  terminating  in  a minute  air-cell.  Over  this 
entire  surface  the  air  is  intended  to  be  brought  into  communication 
with  the  blood  for  the  purpose  of  oxidating  it.  By  forcible  inhala- 
tion, the  air-vesicles  are  inflated  to  the  extent  of  their  capacity,  by 
which  means  the  extreme  branches  of  the  pulmonary  arteries  are  so 
flattened  between  these  extended  cells,  as  to  be  able  to  convey  but  a 
small  amount  of  blood,  and  but  little  is  oxidated.  This  furnishes  a 
mechanical  obstruction  to  the  transmission  of  the  blood,  and  secures 
the  defibrination  of  which  Rokitansky  speaks. 

This  is  my  view  of  the  philosophy  of  atmospheric  inhalation.  The 
benefit  results,  not  from  a larger  amount  of  oxidation,  as  is  generally 
supposed,  but  from  a smaller.  Asthma  does  the  same  thing  by  pro- 
ducing spasmodic  contraction  of  the  extreme  bronchial  tubes,  and 
preventing  air  from  entering  the  cells. 

The  same  end  is  gained  in  part  by  certain  kinds  of  employment,  as 
glass-blowing,  playing  upon  wind  instruments,  and  the  like.  Writers 
of  distinction  mention  cases  of  recovery  from  incipient  consumption 
by  a vigorous  use  of  the  lungs  in  singing.  Dentists  subject  their 
lungs  to  a similar  process  of  expansion  in  the  use  of  the  blow-pipe  ; 
the  writer  has  known  several  instances  in  that  profession,  in  which 
recoveries  have  taken  place. 

The  Conclusion  to  which  I come  is,  that  atmospheric  inhalation 
may  be  used  with  great  advantage  in  some  cases,  but  should  never 
be  resorted  to  except  under  the  direction  of  a competent  physician. 
In  a congested  state  of  the  lungs,  with  hsemorrhagic  tendencies,  or 
with  inflammation  and  soreness,  it  is  well  fitted  to  produce  fatal 
bleeding  and  is  of  course  dangerous. 

External  Use  of  Water. — As  a relaxation  from  severe  exertions, 
the  ancients  had  frequent  recourse  to  bathing.  Those  who  contended 
in  the  race,  throwing  the  javelin,  and  wrestling,  at  Rome,  plunged 
into  the  Tiber  while  warm  and  panting  with  their  efforts.  That  this 
promoted  prowess  and  physical  endurance,  none  can  doubt. 

Louis,  the  great  French  authority  on  pulmonary  diseases,  lays 
down  several  rules  to  be  observed  by  consumptive  patients,  and  par- 
ticularly mentions  cold  bathing. 

Few  things  give  tone  to  the  capillaries  of  the  skin  like  cold  water, 
systematically  applied.  It  rallies  the  powers  of  the  constitution,  and 
improves  assimilation.  And  by  it  another  object  is  gained  of  scarcely 
less  importance.  — that  of  guarding  the  system  against  taking  cold. 


282 


DISEASES  OF  THE  CHEST. 


Those  in  the  daily  habit  of  applying  cold  water  to  the  whole  person 
seldom  suffer  from  colds  and  catarrhs ; they  generally  become  har- 
dened so  as  to  endure  the  assaults  of  the  elements. 

Consumptive  persons  should  generally  use  the  sponge  bath,  with 
cold  water,  if  it  can  be  endured,  otherwise  the  tepid  bath,  to  be  fol- 
lowed, in  all  cases  with  brisk  rubbing,  with  a coarse  towel.  If  a sense 
of  chilliness  and  discomfort  follows  the  bath,  a large  portion  of  the 
water  must  be  squeezed  from  the  sponge,  so  as  to  use  but  very  little, 
and  the  washing  must  be  speedy,  and  the  rubbing  more  lively  than 
usual,  — beginning  with  tepid  water,  and  gradually  lowering  the 
temperature  till  it  can  be  borne  cold.  A large  teaspoonful  of  salera- 
tus  to  each  quart  of  water  should  be  used. 

Diet. 

The  diet,  like  all  other  parts  of  the  treatment,  must  have  reference 
to  the  present  condition  of  the  patient.  If  the  disease  take  the  bron- 
chial form,  and  rapid  breathing,  and  other  conditions  calculated  to 
carry  fat  out  of  the  system  have  not  yet  supervened  ; or  if  the  pa- 
tient have  thirst  and  hectic,  the  diet  must  be  spare  and  simple,  — 
consisting  chiefly  of  milk  and  farinaceous  substances. 

But  in  all  cases  where  the  disease  is  tubercular,  or,  being  bronchial, 
has  reached  the  stage  of  emaciation,  the  very  earliest  moment  at 
which  the  fever  can  be  subdued  should  be  improved  to  build  up  the 
patient  with  a generous  diet.  I have  seen  cases  where  the  stuffing 
sometimes  resorted  to  for  fattening  turkeys  for  Thanksgiving  would 
seem  to  be  almost  justifiable.  A good  rule  is  to  give  the  most  gener- 
ous diet  that  can  be  taken  without  disturbing  the  stomach,  or  increas- 
ing the  feverish  symptoms.  Animal  food  with  a good  quantity  of 
salt  should  be  freely  taken.  Fat  meats,  if  well  received  by  the  stom- 
ach (and  they  generally  are  if  taken  cold},  are  particularly  useful. 
The  same  is  true  of  sweet  butter  and  cream. 

Out=Door  Exercise. — Without  exercise,  as  a general  thing,  the 
consumptive  patient  will  die.  Exercise  involves  muscular  exertion, 
which  is  attended  by  the  tension,  compression,  and  greater  compact- 
ness of  the  muscles  used.  Extend  your  walk  a little  every  day. 
Stretch  it  out  to  the  distant  fields.  Gather  flowers  from  the  top  of 
the  hills  and  from  the  bosom  of  the  valleys,  and  bring  them  home  as 
trophies  of  your  victory. 

If  not  able  to  begin  with  walking,  ride  as  often  as  possible  in  a 
carriage.  The  jolting  of  a vehicle  will  jog  the  blood  along  much 
better  than  no  exercise. 

Horseback  riding  is  still  better.  It  combines,  in  some  measure, 
the  passive  exercise  of  carriage  riding,  with  the  active  exertion  of 
walking  on  foot. 

If  the  person  who  has  only  a small  portion  of  the  lung  affected 
and  whose  general  health  and  strength  has  not  failed,  the  employment 


DISEASES  OF  THE  CHEST. 


283 


of  this  advice  for  exercise  cannot  be  too  strongly  put  forth,  as  it  means 
the  continual  inhalation  of  pure  air,  caused  by  the  exercise,  but  I 
would  not  have  a patient  who  has  perhaps  been  greatly  affected  by 
the  disease,  think  that  the  way  is  not  open  to  him  for  improvement. 
He  will  of  course  not  be  able  to  exercise  so  strenuously,  in  fact,  per- 
haps the  majority  of  cases  do  not  require  as  much  exercise  as  has 
been  advocated,  provided  however,  they  are  placed  in  a 'position 
where  an  abundance  of  fresh  air  is  also  available  and  no  symptoms 
appear  which  show  that  the  strength  is  being  called  upon  too  vigor- 
ously, such  as  the  patient  being  unable  to  sleep  at  night  and  diges- 
tive disturbances  occur.  But  to  the  cases  more  advanced  in  the  dis- 
ease, it  should  be  remembered  that  exercise  will  do  more  harm  than 
good  and  the  whole  question  will  be  an  individual  one  as  no  general 
rules  can  be  laid  down  for  the  patient.  For  as  many  hours  and  days  as 
is  possible,  the  patient  should  be  exposed  to  the  direct  rays  of  the  sun 
and  protected  from  high  winds.  This  may  be  attained  on  a high 
elevation,  such  as  the  roof  of  the  house,  with  a southerly  exposure. 

If  it  is  so  the  patient  can  travel,  some  high,  dry  climate  about  4000 
feet  in  elevation  is  the  best  place,  and  in  selecting  this  resort  the  thing  , 
to  be  considered  is  the  number  of  hours  of  the  sunshine  he  or  she  will 
be  able  to  be  subjected  to.  We  do  not  consider  now  the  degrees  of 
temperature,  if  the  climate  is  free  from  moisture,  as  the  patient  can 
be  properly  clothed  and  be  allowed  to  remain  out  of  doors  all  day. 
The  high  altitude  recommended  is  also  beneficial  because  the  patient 
is  obliged  to  take  deep  breaths,  thus  being  obliged  to  exercise  his 
lungs. 

Colorado  and  certain  parts  of  Arizona  and  New  Mexico  in  the 
United  States,  portions  of  Switzerland  which  have  an  elevation  of 
four  to  five  thousand  feet  above  sea  level,  and  San  Moritz,  abroad, 
are  examples  of  suitable  places. 

Before  leaving  the  subject,  and  for  the  encouragement  of  those 
affected,  from  the  latest  statistics  at  command,  sixty  per  cent,  of 
early  cases  have  been  discharged  well  from  the  Adirondacks  Cottage 
Sanitorium. 

Trudeau,  the  eminent  authority  of  the  United  States,  reports  that 
one-third  of  all  the  cases  under  his  observation  during  the  past  seven- 
teen years  are  well  and  that  two-thirds  of  the  earlier  cases  are  cured 
at  the  present  time.  Thirty  years  ago  physicians  thought  that 
only  two  per  cent,  of  the  cases  were  curable. 

Sea  voyages  are  now  not  recommended,  with  the  dampness  natu- 
rally attending  the  trip,  the  lack  of  comfort  on  the  steamer,  the  short 
length  of  time  consumed  by  the  trip,  its  compulsory  confinement  and 
the  inability  to  eat  nourishing  food,  if  seasickness  is  present,  all 
weigh  against  this  treatment;  in  fact,  from  what  has  been  said,  if 
common  sense  is  used  a great  improvement  can  be  expected  at,  or 
within  a reasonable  distance  of,  the  patient’s  home. 


284 


DISKASES  OF  THE  CHEST. 


Numerous  other  modes  of  exercise  may  be  resorted  to  with  advan- 
tage. Dumb-bells,  adapted  in  size  to  the  strength  of  the  patient, 
and  used  with  caution,  are  liighly  serviceable.  The  battledoor,  the 
football,  bicycle  riding,  pitching  quoits,  and  the  atliletic  sports  of  the 
gymnasium,  all  have  their  appropriate  place.  The  greater  the  variety 
the  better,  as  by  it  all  parts  of  the  system  are  brought  into  play,  and 
both  the  mind  and  the  muscles  get  the  change  which  they  need. 

It  is  hard  to  impress  patients  with  the  importance  of  this  subject. 
Say  wliat  you  will,  they  somehow  or  other  get  the  idea  that  a mod- 
erate amount  of  exercise,  taken  when  they  feel  like  it,  is  all  that  is 
required.  Fatal  mistake  ! Whatever  the  physician  may  do,  the  pa- 
tient has  a great  deal  to  do  for  himself.  He  must  strive  to  develop 
Iris  physical  powers  to  the  utmost.  He  must  train  himself  as  runners 
and  fighters  do  when  preparing  for  their  surprising  feats ; for  he  is 
running  against  the  swiftest  disease  (or  the  surest  winner)  of  our  cli- 
mate, and  fighting  with  the  elements. 

If  he  regards  life  as  not  worth  this  exertion,  of  course  he  will  not 
make  it ; but  I beg  him  to  consider  that  without  it  recovery  will  be 
■ uncertain,  and  in  many  cases,  impossible.  Do  as  I have  directed,  and 
if  your  medical  attendant  is  skilful,  the  current  of  health  will,  in 
many  cases,  begin  to  flow  back  to  you.  Life  will  renew  to  you  its 
policy  of  insurance,  and  multiply  your  days. 

Drugs.  — Tonics  and  bitters  to  help  the  appetite,  iron,  strychnine, 
quinine  in  very  small  doses  as  a tonic;  of  the  heart  supporters  digi- 
talis may  be  given  when  indicated  and  used  carefully  under  the 
advice  of  a physician,  cough  sedatives  of  which,  perhaps,  the  most 
useful  is  one  which  may  now  be  obtained  at  all  drug  stores,  is  the 
Elixir  of  Terpin  hydrate  with  heroin  in  the  dose  of  a teaspoonful 
four  or  five  times  a day. 

Travelling: — Consumptive  patients  have  generally  been  sent  to  a 
southern  climate.  But  where  the  case  involves  dyspepsia  and  affec- 
tions of  the  liver,  low  latitudes  are  generally  unfriendly.  Liver  com- 
plaints are  the  bane  of  a southern  climate,  and  a sallow  complexion  is 
the  inheritance  of  a southerner. 

Tubercular  persons,  chilled  by  our  northern  climate,  are  sometimes 
temporarily  relieved  by  the  warmer  atmosphere  of  the  south.  But 
the  relief  is  only  temporary ; for,  having  lost  the  power,  as  they  im- 
agine, to  bear  the  frowns  of  our  northern  sky,  they  are  dying,  and 
will  die  anywhere  unless  they  recover  this  power.  And  the  way  to 
retrieve  a lost  advantage  over  an  enemy,  is,  not  to  retreat  to  a point 
where  recovery  will  be  harder,  but  to  meet  him  at  once.  If  the  con- 
stitution cannot  bear  up  against  an  enemy  under  the  bracing  of  a 
northern  atmosphere,  it  will  be  still  harder  to  do  so  under  the  wilting 
of  a southern. 

After  all,  the  objects  aimed  at  should  be  change  and  travelling. 
The  exercise  involved,  the  cougtant  exertion  required  in  getting  from 


DISEASES  OF  THE  CHEST. 


285 


place  to  place,  the  agreeable  sensations  produced  by  the  motion  of 
cars  and  steamboats,  the  ever  varying  change  of  sights  and  sounds, 
and  the  constantly  increasing  stock  of  one’s  ideas  of  men  and  things, 
— these  are  what  rally  the  constitution,  and  open  anew  the  springs 
of  life. 

Especially  should  all  journeys^  for  health  be  taken,  if  possible,  with 
an  object  in  view.  Let  the  consumptive  start  with  the  view  of  see- 
ing the  cave  of  Kentucky,  the  prairies  of  the  West,  the  great  lakes 
of  the  North,  the  falls  of  Niagara,  the  fortress  of  Quebec,  the  Sague- 
nay river,  the  doctor,  who  he  has  reason  to  think  Avill  cure  him,  — 
anything  which  he  is  willing  to  make  exertion  to  see,  and  that  he  is 
sure  his  eyes  will  rejoice  in  beholding. 

I have  thus  spoken  of  consumption  more  at  large  than  of  other 
complaints,  because  it  is  the  great  disease  of  the  world,  and  is  in- 
creasing with  the  advancement  of  civilization. 

Acute  Bronchitis. 

This  is  an  acute  inflammation  of  the  mucous  membrane  lining  the 
air-tubes  in  the  lungs.  It  is  generally  quite  a serious  disease. 

Physical  Signs.  — The  sound  upon  percussion  is  generally  good. 
If  there  be  any  dullness,  it  is  commonly  in  tbe  lower  and  back  part 
of  the  chest.  This  occurs  only  in  “Capillary  Bronchitis.” 

The  breathing  murmurs  are  sometimes  more,  sometimes  less  in- 
tense than  natural.  Occasionally  they  are  almost  extinct. 

In  the  early  stage,  sibilous  and  loud  rattles. 

In  the  more  advanced  stage,  mucous  rattle. 

Now  and  then  sub-crepitant  rattle  accompanies  tbe  inward-drawn 
breath. 

General  Symptoms.  — The  disease  begins  with  chills  followed  by 
fever;  tightness  across  the  chest,  difficulty  of  breathing,  hoarseness, 
loss  of  strength,  costive  bowels,  and  a quick  and  hard  pulse.  Water 
runs  from  the  eyes  and  nostrils,  and  there  is  a dry,  harsh,  croupy 
cough. 

After  a few  days,  mucus  begins  to  be  raised.  This  expectoration 
gradually  becomes  more  copious,  and  is  opaque,  yellowish,  or  green- 
ish, and  occasionally  streaked  with  blood.  This  mucus  is  very  ropy 
and  adheres  to  the  vessel. 

There  is  more  or  less  pain  in  tbe  chest ; pain  across  the  forehead, 
which  is  increased  by  coughing;  and  a pale  and  anxious  countenance. 

In  severe  cases,  the  tightness  across  the  chest  is  extreme,  with  a 
sense  of  suffocation,  causing  the  patient  to  call  for  the  opening  of 
the  windows.  There  is  great  difficulty  of  breathing ; a paleness  and 
lividity  of  the  cheeks  and  lips ; a loud  wheezing  and  rattling  in  the 
throat,  followed  by  cold  sweat,  insensibility  and  death. 

In  children  the  disease  comes  on  like  a common  cold,  attended  by 


286 


DISEASES  OF  THE  CHEST. 


a sore  throat,  a great  desire  to  drink,'  but  a disinclination  to  take 
food.  But  two  or  three  swallows  of  di’ink  can  be  taken  at  a time 
for  want  of  breath.  The  phlegm  is  frequently  vomited  up  spon- 
taneously. 

Observations.  — The  loud  and  sibilous  rattles  are  produced  by 
similar  causes,  namely,  the  passage  of  air  along  tubes  whose  interior 
is  dry  and  rough  from  inflammation,  or  whose  calibre  is  contracted  or 
altered  in  form  by  the  swelling  of  the  membrane,  effusion  upon  its 
inner  surface  of  a tough,  mucous  substance,  or  a pressure  upon  its 
external  surface  of  tubercles,  swollen  glands,  aneurism al  tumors, 
etc.  The  two  sounds  differ  mainly  in  the  key  upon  which  they  are 
pitched,  — the  sonorous,  or  low-keyed,  coming  from  the  larger  tubes; 
the  sibilous,  or  high-keyed,  from  the  smaller,  — just  as  the  low  notes 
of  an  organ  come  from  the  large  pipes,  and  the  high  notes  from  the 
small  ones. 

Causes.  — It  is  generally  brought  on  by  a sudden  cold,  by  changes 
of  the  weather,  and  by  inhaling  irritating  substances.  It  is  a second- 
ary result,  too,  of  scarlet  fever,  measles,  small-pox,  hooping  cough, 
and  the  remittent  fever  of  infants. 

Treatment,  — In  mild  cases,  give  warm  balm  or  flax-seed  tea,  hot 
lemonade,  or  other  similar  drinks,  — at  the  same  time  soaking  the 
feet  in  hot  water,  and,  on  retiring  to  bed,  apply  bottles  of  hot  water 
to  the  feet  and  sides,  to  produce  sweating.  If  the  bowels  be  costive, 
some  gentle  physic,  as  rhubarb  and  magnesia,  or  salts  and  senna,  may 
be  taken. 

Chloride  of  ammonia  in  teaspoonful  doses  diluted  in  water  and 
citrate  of  potassium  in  10  to  20  grain  doses,  or  better  still,  a mix- 
ture of 

Chloride  of  ammonia,  3 drachms  or  teaspoonfuls. 

Citrate  of  potassium,  4 “ “ 

Compound  licorice  mixture,  3 ounces. 

Shake  the  bottle. 

Take  of  the  above,  one  teaspoonful  diluted  with  water  every  three 
hours. 

In  the  case  of  infants,  an  emetic  of  wine  of  ipecac,  or  compound 
tincture  of  lobelia,  should  be  given,  and  followed  jvith  slippery  elm 
find  flax-seed  tea.  The  compound  tincture  of  lobelia,  with  tincture 
of  veratrum  viride,  may  be  continued  for  a time  as  an  expectorant. 

In  more  severe  cases,  both  of  adults  and  children,  an  active  emetic 
is  required,  — perhaps  the  compound  powder  of  lobelia  is  as  good  as 
any.  This  must  be  followed  with  tincture  of  veratrum  viride,  in  full 
doses,  so  as  to  reduce  the  pulse  at  once,  and  keep  it  down  to  the 
natural  standard.  This  is  one  of  the  very  best  articles  in  this  com- 
plaint, and  will  generally  very  much  lessen  its  violence  and  duration, 

If  there  is  much  difficulty  of  breathing,  the  air  of  the  room  must 
be  kept  moist,  as  recommended  in  croup. 


DISEASES  OF  'THE  CHEST. 


287 


The  room  should  also  be  kept  warm,  - — decidedly  warmer  than  in 
the  case  of  other  fevers. 

A gentle  perspiration  should  be  kept  up  by  small  doses  of  com- 
pound tincture  of  Virginia  snake-root,  and  by  frequently  bathing  the 
surface,  or  else  by  tincture  of  veratrum. 

Mustard  should  be  applied  to  the,  chest,  and  to  the  soles  of  the  feet. 

The  cough  may  be  managed  by  preparations  (104),  (106),  (110), 
freely  given. 

The  diet  should  be  confined  to  barley-water,  toast-water,  apple- 
water,  rice-water,  and  a solution  of  gum-arabic. 


Chronic  Bronchitis. 

This  is  an  inflammation  of  the  mucous  membrane  of  the  air-tubes, 
which  continues  a great  length  of  time,  without  any  sudden  or  re- 
markable changes. 

Physical  Signs.  — The  percussion-sounds  are  similar  to  those  of 
acute  bronchitis.  When  a bronchial  tube  is  dilated,  we  sometimes 
have  dullness  around  the  dilated  part. 

The  breathing  murmur  is  always  accompanied  by  a mucous,  sono- 
rous, or  sibilant  rattle,  — sometimes  by  a subcrepitant. 

When  dilatation  of  the  tubes  exists,  the  intensity  and  duration  of 
the  sound  of  the  ingoing  breath  is  decreased^  — of  the  outgoing 
increased. 

In  this  state  of  the  tubes,  we  also  have  cavernous  breathing,  bron- 
chophony, sometimes  pectoriloquy,  and  bronchial  or  cavernous  cough. 

General  Symptoms.  — A cough  is  generally  present,  which  is  in- 
creased in  wet  weather,  and  by  every  slight  cold.  This  comes  on  in 
paroxysms ; is  generally  worse  in  the  morning ; and  is  relieved  by 
raising  freely.  The  matter  raised  is  generally  yellowish,  but  some- 
times whitish  and  sticky;  and  in  the  latter  stages  is  thick,  and 
sometimes  very  much  like  that  of  consumption.  Indeed,  the  disease 
often  ends  in  bronchial  consumption. 

Remarks.  — The  breathing  is  bronchial  or  cavernous  when  the 
dilated  portion  of  the  tube  is  empty ; if  it  contain  fluid,  the 
mucous  rattle  will  be  heard. 

Dullness  on  percussion  will  exist  if  a dilated  tube  press  upon  the 
surrounding  portion  of  lung  so  as  to  condense  or  make  it  solid. 

Dilatation  of  the  tubes  occurs  only  in  chronic  bronchitis  of  long 
standing.  Its  physical  signs  are  much  like  those  of  a cavity  in  ad- 
vanced consumption.  The  examiner  may  learn  to  distinguish  them 
by  considering  that  in  consumption,  dullness  precedes  the  cavity.,  while 
in  bronchial  dilatations,  the  cavity  precedes  dullness. 

The  dilatation  or  swelling  out  at  some  point  of  a bronchial  tube 
is  caused  by  obstructions  to  the  passage  of  air  through  it,  — just  as 


288 


DISEASES  OF  THE  CHEST. 


an  India-rubber  tube,  partially  closed  up  at  a given  point,  will  bulge 
out  just  in  front  of  the  obstructed  place,  when  air  is  forcibly  blown 
through  it,  and  just  as  the  left  ventricle  of  the  heart  enlarges  when 
the  blood  is  obstructed  in  its  passage  through  the  aortic  valve. 

Causes.  — It  often  occurs  as  the  result  of  acute  bronchitis,  and 
also  of  measles,  hooping-cough,  etc.  But  taking  cold,  and  damp  and 
changeable  weather,  are  more  frequently  its  causes.  It  most  often 
follows  chronic  inflammations  of  the  throat,  which,  being  neglected, 
gradually  creep  down  the  windpipe  into  the  tubes,  and  become  very 
obstinate  in  their  character. 

Treatment.  — Medicinal  inhalation  is  one  of  the  best  remedies  for 
this  complaint.  The  inhaling  powder  has,  in  many  cases,  great 
efficiency.  The  dose  is  about  what  can  lie  on  a ten-cent  piece.  It 
should  be  used  once  a day,  in  an  instrument  represented  in  the  cut. 

This  instrument  I had  constructed  for  my  use.  It  consists  mainly 

of  a glass  tube  and  a receiver,  — 
the  latter  being  something  like  a 
tube-vial,  pierced  with  fine  holes 
around  the  lower  end.  The  pow- 
der is  poured  into  the  receiver, 
which  is  placed  in  the  larger  tube, 
and  twirled  between  the  thumb  and  finger  while  inhaling. 

When  the  powder  cannot  be  easily  got  down  into  the  tubes  in  the 
lungs,  — as  often  happens,  — the  inhalation  of  medicated  vapor  will 
do  better.  If  the  expectoration  be  difficult,  the  expectorant  inhalant, 
described  under  “consumption,”  should  be  used;  if  the  expectoration 
be  too  profuse  and  free,  the  astringent  inhalant  must  be  taken. 

The  cough  preparations  recommended  for  consumption,  also  (113), 
(112),  will  be  the  proper  ones  in  this  complaint. 

The  daily  alkaline  bath,  and  brisk  friction,  are  particularly  service- 
able. 

Out-door  exercise  is  almost  as  necessary  in  this  disease  as  in  con- 
sumption. 

Enlargement  of  the  Air-Cells.  — Emphysema. 

This  disease  consists  in  enlargement  of  the  air-cells,  the  oblitera- 
tion of  their  vessels,  and  the  wasting  of  their  walls. 

Physical  Signs.  — Thumping  upon  the  chest  gives  a clearer  and 
louder  sound  than  natural,  — one  which  is  tympanitic,  or  drum-head 
like. 

The  murmur  of  the  ingoing  breath  is  diminished  both  in  duration 
and  intensity,  — of  the  outgoing  breath,  it  is  increased. 

Dry,  crepitant  rattle  attends  the  ingoing  breath  only;  occasionally, 
sibilous  rattle. 


DISEASES  OE  THE  CHEST. 


289 


General  Symptoms.  — HaHtual  shortness  of  breath,  and  very 
great  difficulty  of  breathing,  occurring  in  paroxysms,  which  cause 
the  patient  to  rush  to  the  open  window  for  air. 

There  is  generally  a cough,  and  the  matter  raised  is  frothy,  liquid, 
and  mucous,  or  watery. 

The  face  has  a peculiar  dusky  color,  and  the  countenance  an  anx- 
ious, melancholy  expression.  The  nostrils  are  thick,  and  the  lower 
lip  full.  The  muscles  of  the  neck  are  large,  and  the  gait  of  the  pa- 
tient is  stooping.  The  strength  is  wasted  in  proportion  to  the  diffi- 
culty of  breathing. 

Emphysema  tends  to  produce  disease  of  the  heart,  Bright’s  disease, 
and  venous  congestions  in  the  head. 

Observations. — The  tympanitic  sound  is  caused  by  the  increased 
amount  of  air  in  the  cells. 

The  air-cells  have  lost  their  elasticity,  the  air,  in  a great  degree, 
remains  in  them,  — not  passing  in  and  out,  — hence  the  absence  of  the 
vesicular  murmur. 

The  crepitant  rattle  attends  the  ingoing  breath  only,  and  is  sup- 
posed to  arise  from  the  expansion  of  the  lungs  which  are  in  a drier 
state  than  natural.  It  has  been  compared  to  the  sound  producd  by 
blowing  into  a dried  bladder. 

Treatment. — To  whatever  extent  the  air-cells  are  destroyed,  to 
that  extent,  of  course,  the  disease  is  incurable.  It  may,  however,  be 
palliated  and  relieved  to  a great  extent. 

Generally,  bronchitis  exists  in  connection  with  emphysema ; and 
when  this  is  found  to  be  the  case,  the  remedies  for  that  disease  must 
be  employed.  (370)  often  is  curative. 

The  inhalation  of  tincture  of  stramonium,  in  one  or  two  teaspoon- 
ful doses,  the  same  as  the  alterative  inhalant  is  used,  will  be  useful. 

To  be  taken  internally,  an  excellent  preparation  may  be  made  by 
uniting  one  dram  of  etheral  tincture  of  lobelia  with  two  drams  of 
tincture  of  ipecac,  and  two  ounces  of  ammoniac  mixture.  The  dose 
is  one  or  two  tablespoonfuls.  Half-grain  to  grain  doses  of  extract  of 
cannabis  indica  are  excellent  to  relieve  the  difficulty  of  breathing. 

The  diet  must  be  very  carefully  regulated,  as  overindulgence  at  the 
table  aggravates  the  symptoms. 

Change  of  air  is  often  highly  beneficial ; but  it  is  impossible  to 
predict  its  effect  beforehand  in  each  individual  case. 

Swelling  of  the  Lungs.  — Hypertrophy  of  the  Lungs. 

This  can  hardly  be  regarded  as  a disease.  It  generally  takes  place 
in  but  one  lung,  and  is  the  result  of  the  inaction  of  the  other.  Thus, 
when  one  lung  is  diseased,  the  other  has  to  do  the  work  of  both  ; and 
being  overworked,  it  enlarges,  as  the  heart  or  an  arm  does  when  very 
much  exercised. 


290 


DISEASES  OF  THE  CHEST. 


The  only  treatment  required  is  to  eat  sparingly,  and  exercise  with 
great  moderation,  so  as  not  to  increase  the  rapidity  of  the  breathing. 

Pulmonary  Apoplexy. 

This  is  generally  the  result  of  a disease  of  the  heart,  particularly 
of  the  mitral  valve. 

Physical  Signs.  — Percussion  yields  a clear  sound,  except  where 
the  engorgement  of  blood  is  large,  and  near  the  surface,  — in  which 
case,  it  is  dull. 

The  sound  of  breathing  is  feeble  or  absent  over  a limited  space. 

Bronchial  breathing  is  heard  in  some  places,  and  bronchophony  in 
part,  in  the  same  regions. 

Mucous  rattle  is  also  heard. 

Observations.  — In  this  disease  the  small  air-tubes  and  air-cells  are 
the  seat  of  bleeding ; and  the  blood  becoming  coagulated  here,  closes 
these  vessels  against  the  entrance  of  air.  This  explains  the  feeble- 
ness or  absence  of  the  breathing  murmur. 

The  fluidity  of  blood  in  the  immediate  vicinity  gives  rise  to  the 
mucous  rattle. 

General  Symptoms.  — These  are,  difficulty  of  breathing,  tightness, 
and  dull  pain  in  the  chest.  The  mucus  raised  is  tinged  or  streaked 
with  blood.  The  blood  raised  is  darkish,  and  dirty-looking.  This 
last  symptom,  the  dirty  look  of  the  blood,  is  peculiar  in  this  disease. 

Treatment.  — The  most  important  remedy  is  dry-cupping  upon  the 
chest.  This  will  often  arrest  the  disease  at  once.  Counter-irritation 
by  croton-oil  is  also  useful.  A free  movement  of  the  bowels  by  a 
preparation  containing  croton-oil,  or  elaterium  (31),  (33),  has  an  ex- 
cellent effect. 

Air  in  the  Chest.  — Pneumothorax. 

This  disease  consists  in  the  presence  of  air  in  the  cavity  of  the 
pleura.  Generally,  there  is  also  water  in  the  pleural  sac  at  the  same 
time  ; the  water,  being  the  heavier  fluid,  occupying  the  lower  part  of 
the  cavity,  and  the  air  the  upper  part. 

Physical  Signs.  — Tympanitic  or  drum-like  sound  over  the  upper 
part  of  the  side.  Dull  sound  over  the  lower  part.  Breathing  mur- 
mur diminished  or  suppressed.  Amphoric  breathing.  Metallic  tink- 
ling. 

General  Symptoms.  — Great  oppression  of  the  chest,  and  difficulty 
of  breathing ; generally  attended  by  palpitation  of  the  heart,  and  fre- 
quently by  severe  pain  under  the  breast-bone,  on  the  affected  side. 
The  patient  generally  has  to  remain  in  the  sitting  posture,  and  can- 
not lie  an  instant  on  the  sound  side, 


DISEASES  OF  THE  CHEST. 


291 


If,  on  percussion,  one  side  of  the  chest  sounds  louder  than  the 
other  and  the  breathing  murmur  is  heard  distinctly  on  the  side  which 
gives  only  a moderate  sound,  and  is  not  heard  at  all  on  the  loud- 
sounding  side,  we  may  he  sure  it  is  a case  of  air  in  the  chest. 

Observations. — The  metallic  tinkling  is  like  the  sound  produced 
by  dropping  a pin’s  head  into  a metallic  dish,  or  like  the  distant  tink- 
ling of  a sheep-bell,  or  the  gentle  pulling  of  the  string  of  a violin. 

It  is  supposed  that  when  the  fluid  in  the  cavity  of  the  pleura  hap- 
pens to  be  higher  than  the  orifice,  the  air,  when  it  enters  at  each 
in-drawn  breath,  forces  its  way  up  through  the  fluid,  in  the  shape  of 
bubbles,  and,  bursting  at  the  surface,  gives  the  tinkling  sound.  This 
sound  is  sometimes  produced,  too,  by  the  falling  of  drops  of  liquid 
from  the  upper  part  of  the  cavity,  upon  the  surface  of  the  fluid. 

The  amphoric  breathing  is  like  the  sound  produced  by  blowing 
obliquely  into  an  empty  cask.  One  writer  says  he  heard  the  same 
sound  Avhen  out  shooting  on  a rough  day,  produced  by  the  wind  blow- 
ing sideways  into  the  gun-barrel. 

Treatment. — I would  recommend  the  use,  two  or  three  times  a 
day,  of  the  antiseptic  inhalant,  mentioned  under  the  head  of  con- 
sumption. 

To  this  should  be  added  dry-cupping  over  the  whole  chest,  which 
generally  gives  great  relief.  Blisters  may  also  be  used. 

Sweating  must  be  encouraged  in  the  manner  recommended  under 
acute  bronchitis. 

For  the  difficulty  of  breathing,  give  half-grain  doses  of  cannabis 
indica,  or  five-drop  doses  of  tincture  of  aconite,  or  one-sixth  of  a 
grain  doses  of  svapnia.  Extract  of  belladonna,  or  of  stramonium,  is 
also  worthy  of  trial. 

Water  in  the  Chest. — Hydrothorax. 

This  disease  consists  in  a collection  of  water  in  the  cavity  of  the 
pleura. 

Physical  Signs. — There  is  a dull  sound  over  the  effusion. 

The  breathing  murmur  is  diminished,  and  gradually  disappears 
altogether  over  the  space  occupied  by  the  effusion. 

Bronchial  breatliing  is  heard  in  the  same  part. 

When  the  amount  of  fluid  is  small,  egophony  is  heard  in  the  mid- 
dle regions  of  the  chest. 

Bronchophony  is  heard  when  the  effusion  is  larger. 

General  Symptoms. — Either  upon  lying  down,  or  using  active 
bodily  exercise,  the  patient  finds  his  difficulty  of  breathing  increased. 
When  in  bed,  he  lies  with  his  head  and  shoulders  raised,  which,  by 
causing  the  fluid  to  settle  at  the  bottom  of  the  cavity,  prevents,  in  a 
measure,  its  pressure  upon  the  lungs,  and  gives  him  a little  rest. 


292 


DISEASES  OF  THE  CHEST. 


His  sleep  is  interrupted  by  sudden  starts  with  alarm  and  terror.  The 
pulse  is  hard,  the  thirst  great,  the  urine  scanty  and  high-colored,  and 
has  a sediment.  After  a time  the  feet  swell,  the  face  is  pallid  and 
livid,  and  the  countenance  expresses  anxiety  and  alarm.  There  is  a 
short,  dry  cough. 

When  the  quantit}^  of  fluid  in  the  chest  becomes  large,  the  patient 
cannot  lie  down  at  all,  and  only  gets  short  and  disturbed  naps  in  the 
sitting  posture. 

Of  all  the  symptoms,  the  starting  m sleep  is  the  most  certain  sign 
of  the  disease. 

Causes. — In  some  rare  cases,  this  may  occur  as  a primary  disease, 
— that  is,  as  a disease  not  dependent  upon  any  other  as  its  cause. 
The  greater  number  of  cases,  however,  are  secondary.  They  arise 
from  organic  disease  of  the  heart,  or  liver,  or  stomach.  Inflammation 
of  the  pleura  is  a very  frequent  cause. 

A plethoric,  or  full  state  of  the  system,  predisposes  to  this  com- 
plaint,— particularly  in  those  persons  who  indulge  freely  at  the 
table. 

It  may  arise,  too,  from  the  striking  in  of  skin  eruptions ; from  the 
free  use  of  liquors ; and  from  frequent  excessive  bleedings  or  purg- 
ings. 

Treatment. — Dry-cupping  is  a valuable  remedy,  and  should  al* 
ways  be  practised. 

The  chest  should  be  painted  with  the  tincture  of  iodine,  and  a 
good  degree  of  substantial  soreness  be  kept  up. 

The  internal  remedies  are  purges  (31),  (14),  (30),  and  diuretics 
(128),  (129),  (130),  (131)  when  the  patient  is  not  very  weak. 

The  iodide  of  potassium,  in  doses  of  five  or  six  grains,  once  in 
three  or  four  hours,  is  an  excellent  remedy.  The  following  is  a good 
form  of  taking  it:  iodide  of  potassium,  one  ounce;  fluid  extract  of 
pipsissewa,  two  ounces ; water,  half  a pint.  Dose,  one  teaspoonful. 

The  skin  should  be  bathed  and  rubbed  daily,  three  or  four  times, 
with  much  friction.  Tapping  the  chest  should  be  done  when  the 
fluid  persists  any  length  of  time,  otherwise  a simple  hydrothorax  may 
become  a doubly  serious  empyema  or  pus  in  the  chest. 

Pleurisy.  — Pleuritis. 

Pleubisy,  or  pleurisy  fever,  as  it  is  sometimes  called,  is  an  in- 
flammation of  the  pleura,  or  the  membrane  which  lines  the  chest, 
and,  at  the  same  time,  is  folded  back  so  as  to  cover  the  outer  surface 
of  the  lungs. 

The  pleura,  as  is  elsewhere  explained,  is  a short  sac  or  bag,  whose 
inner  sides  are  kept  moist,  so  that  they  may  slide  easily  upon  each 
other  as  they  are  moved  by  the  alternate  contractions  and  expansions 
of  the  lungs  in  the  act  of  breathing,  and  whose  outer  sides  are  made 
to  grow, — one  to  the  inside  of  the  chest,  and  the  other  to  the  out- 
side of  the  lungs. 


Diseases  of  the  chest. 


293 


Pleurisy  and  lung-fever,  then,  must  be  kindred  diseases,  and  exist, 
more  or  less,  together.  In  truth  there  is  almost  always  some  affec- 
tion of  the  pleura  in  lung-fever,  and  some  affection  of  the  lungs  in 
pleurisy.  The  pain  in  lung-fever  is  owing  to  some  inflammation  of 
the  pleura ; and  the  appearance  of  the  rusty-colored  phlegm  in  pleu- 
risy indicates  that  the  lungs  have  been  reached  by  the  inflammation 
of  the  membrane  which  covers  them. 

Physical  Signs. — Flatness  on  percussion,  at  the  lower  part  of  the 
chest,  which  ascends  as  the  effusion  of  water  increases. 

If  the  effused  fluid  is  not  great,  there  is  puerile  breathing  at  the 
top  of  the  lung. 

Friction  sound  is  heard  occasionally  in  first  stage  of  disease. 

Egophony  is  heard  when  the  amount  of  fluid  in  the  pleura  is 
small. 

As  the  amount  of  water  increases,  bronchophony  appears. 

General  Symptoms.  — This  disease  is  most  frequently  introduced 
by  iMverings^  which  are  soon  succeeded  by  liigh  fever,  with  a pecu- 
liarly hard,  resisting  pulse;  sharp,  stabbing  pain  in  the  side, — gener- 
ally just  below  the  nipple,  but  sometimes  extending  to  the  shoulder, 
arm-pit,  and  back ; hurried  and  interrupted  breathing ; and  a short, 
dry  cough. 

The  pain  is  greatly  aggravated  by  motion,  coughing,  or  an  attempt 
to  take  a long  breath.  It  holds  the  patient  under  constant  and 
powerful  restraint.  We  find  him  lying  upon  Ifis  back,  or  his  well 
side ; his  countenance  full  of  anxiety,  — fearing  to  move,  cough,  or 
even  breathe  needlessly ; and  often  crying  out  from  the  keen  torture 
these  necessary  acts  inflict  in  spite  of  all  his  caution. 

At  a more  advanced  stage,  when  the  tenderness  has  somewhat 
abated,  he  will  prefer  to  lie  on  the  diseased  side,  as  this  leaves  the 
healthy  lung  more  at  liberty. 

Observations.  — The  first  effect  of  the  inflammation  of  the  pleura 
is  to  dry  up  the  moisture  with  which  its  inner  surfaces  are  lubricated, 
or  made  smooth  and  slippery.  As  a consequence,  these  surfaces  be- 
come rough,  and  rub  harshly  upon  each  other,  and  produce  a sound, 
in  the  early  stages  of  pleurisy,  like  that  of  rubbing  two  pieces  of  wet 
leather  together.  It  may  be  imitated  by  rubbing  the  finger  back  and 
forth  upon  a table.  It  is  sometimes  a creaking  noise,  like  that  of 
new  shoes. 

As  the  disease  advances  an  important  change  takes  place  in  the 
state  of  things.  Instead  of  an  unnatural  dryness,  a watery  fluid  is 
poured  out  copiously  from  the  inflamed  surfaces  of  the  pleural  sac. 
This  is  called  the  period  of  effusion.  This  generally,  though  not  al- 
ways, relieves  the  pain.  But,  by  compressing  the  lung,  causes  dan- 
gerous difficulty  of  breathing. 

The  air-cells  are  compressed  by  the  effused  fluid,  and  are  not 
penetrated  by  air.  Hence  the  absence  of  the  breathing  murmur. 


294 


DISEASES  OF  THE  CHESt. 


The  pouring  out  of  water  between  the  layers  of  the  pleura,  com- 
presses the  lung,  and  removes  it  from  the  walls  of  the  chest.  Hence 
the  dullness  or  deadness  of  sound  upon  percussion. 

When  listening  with  the  stethoscope,  the  voice  of  the  patient 
sounds  feeble  and  interrupted,  like  the  bleating  of  a goat,  and  is 
hence  termed,  egophony,  or  goat-voice. 

This  peculiar  voice  is  heard  only  when  the  effusion  of  water  has 
been  moderate  in  quantity,  and  only  a thin  layer  of  liquid  lies  be- 
tween the  ribs  and  lung.  It  is  caused  by  the  voice  passing  over  tliis 
thin  layer,  which  is  thereby  thrown  into  vibrations.,  or  wavy,  quivering 
motions.  When  thus  agitated,  the  fluid  reacts  upon  the  voice, 
making  it  sharp  and  tremulous. 

When  the  effusion  has  become  large,  these  effects  cease ; but  an- 
other sign  then  shows  itself,  and  distinguishes  pleurisy  from  the 
healthy  state,  and  likewise  from  the  solid,  hepatized  state  of  the 
lung  in  lung-fever.  It  may  be  discovered  thus : 

If  the  hand  be  laid  flat  upon  the  chest  of  a healthy  person,  while  . 
he  is  speaking,  a vibration  or  thrill  will  be  left.  If,  in  like  manner, 
the  hand  be  laid  upon  the  chest  of  a person  having  lung-fever,  with 
hepatized  lung,  this  thrill  will  be  found  still  more  perceptible.  But 
when  the  hand  is  placed  over  the  place  of  watery  effusion  on  the 
chest  of  a person  having  pleurisy,  there  will  be  discovered,  when  the 
person  speaks,  no  thrill  whatever.  The  absence  of  this  thrill,  then,  is 
one  of  the  very  best  signs  of  pleurisy  ivith  effusion. 

Persons  recover  from  pleurisy  sometimes  very  rapidly,  before  effu- 
sion has  taken  place.  It  is  then  said  they  have  had  an  attack  of  dry 
pleurisy.  When  liquid  has  been  poured  out,  even  in  considerable 
quantity,  it  is  sometimes  reabsorbed,  and  the  patient  recovers  per- 
fectly. In  other  instances,  it  compresses  the  lungs,  interferes  seri- 
ously with  breathing,  reduces  his  strength,  and  he  sinks  rapidly. 

Treatment.  — Pleurisy  has  been  divided  for  description  and  treat- 
ment into  three  stages,  following  the  natural  events  of  the  inflamma- 
tion. The  first  stage  comprises  the  period  from  the  first  onset  to  the 
time  when  effusion  commences.  The  second  stage,  or  stage  of  effu- 
sion, extends  to  the  time  when  the  liquid  begins  to  diminish ; and 
the  third  stage  consists  of  the  period  occupied  by  the  absorption  of 
the  liquid. 

Should  the  quantity  remain  stationary  or  diminish  very  slowly 
after  the  lapse  of  two  or  three  weeks,  the  disease  becomes  chronic. 

The  indication  for  treatment  during  the  first  stage  is  to  arrest  the 
progress  of  the  disease,  to  diminish  its  intensity,  to  limit  the  amount 
of  morbid  products,  and  to  relieve  suffering. 

If  the  patient  is  robust,  has  a hard,  frequent  pulse,  accompanied 
with  extreme  pain  and  fever,  blood-letting  is  indicated.  The  abstrac- 
tion of  ten  to  fifteen  ounces  of  blood  will  give  great  relief  and 
diminish  the  intensity  of  the  attack ; but  if  the  patient  is  not  seen 
early,  and  is  of  a feeble  constitution,  some  other  measures  should  be 


DISEASES  OF  THE  CHEST. 


295 


substituted  for  it.  The  mass  of  blood  may  be  lessened  by  saline 
cathartics,  such  as  the  sulphate  of  magnesia,  or  the  bitartrate  of 
potash  in  combination  with  jalap. 

The  effect  of  a full  dose  of  Epsom  salts  is  equal  to  the  abstraction 
of  a pint  of  blood  from  the  system.  Depletion  is  obtained  this  way 
without  the  impoverishment  of  the  blood. 

Tlie  frequency  and  force  of  the  heart’s  action  may  also  be  affected 
by  the  nauseant  sedatives,  such  as  tartarized  antimony  and  ipecacu- 
anha, and  by  the  direct  sedatives,  such  as  the  tincture  of  aconite  and 
of  veratrum  viride  ; therefore,  if  blood-letting  is  contra-indicated,  the 
first  thing  to  be  done  is  to  give  the  sulphate  of  magnesia,  and  follow 
it  with  some  diaphoretic  like  (130),  to  alleviate  the  painful  stitch  in 
the  side  and  to  tranquillize  the  system. 

It  is  well  to  administer  salicylate  of  soda  in  10-grain  doses  every 
three  hours  till  a little  ringing  is  heard  in  the  ears,  then  once  in  four 
hours.  This  drug  increases  the  action  of  the  skin  and  kidneys  and 
overcomes  the  rheumatic  element  present  in  most  if  not  all  pleurisies. 
The  diet  should  be  dry,  all  liquids  being  excluded,  that  the  abstrac- 
tion of  water  from  the  chest  may  be  favored. 

Nothing  gives  so  much  and  such  immediate  relief  to  pain  as  a 
subcutaneous  injection  of  morphine.  Aconite  also  is  a valuable 
sedative  in  this  stage.  It  may  be  given  in  half  or  whole-drop  doses 
every  fifteen  minutes  for  two  hours ; then  afterwards  a drop,  to  be 
repeated  hourly  till  some  impression  is  made  upon  the  heart’s  action. 
Smaller  doses  are  to  be  given  if  the  pulse  becomes  feeble. 

In  the  second  stage,  if  the  acute  symptoms  have  yielded  to  treat- 
ment, as  they  usually  do,  the  object  of  treatment  is  to  promote  the 
absorption  of  the  fluid.  This  is  done  by  the  judicious  use  of  saline 
cathartics  and  by  diuretics,  for  the  bowels  and  the  kidneys  are  the 
natural  pumps  of  the  system. 

The  application  of  counter-irritants  is  also  of  use  for  this  purpose, 
such  as  the  tincture  of  iodine,  and  small  blisters,  which  are  to  be 
allowed  to  remain  on  till  vesication,  and  then  the  blister  is  to  be 
dried  up  and  a new  one  applied.  If  at  any  time  during  this  stage 
the  effusion  is  rapid  and  excessive,  so  as  to  endanger  life,  it  is  to 
be  drawn  off  by  puncturing  the  chest  between  the  fifth  and  sixth 
ribs  on  the  side  with  a small  trocar,  and  the  fluid  is  to  be  drawn  off 
by  suction. 

Convalescence  commences  when  the  liquid  begins  to  be  absorbed ; 
and  active  medication  should  then  cease,  and  that  course  should  be 
pursued  which  will  lead  to  the  restoration  of  the  general  health. 
This  is  done  by  tonics,  a nutritious  diet,  and  other  hygienic  means. 
If  the  effusion  ceases  to  be  absorbed  or  the  process  takes  place  very 
slowly,  then  that  state  of  things  exists  which  is  called  chronic  pleu- 
risy. Then  the  main  objects  of  treatment  are  to  effect  the  removal 
of  the  fluid,  and  to  develop  and  sustain  the  powers  of  the  system. 
Under  these  circumstances,  it  is  better  to  discontinue  remedies  which 
act  upon  the  bowels  and  kidneys,  at  least  for  a time,  and  try  general 


296 


DISEASES  OF  THE  CHEST. 


treatment.  This  consists  of  tonics,  stimulants,  and  general  exercise 
in  the  open  air,  and  with  this  the  surgical  removal  of  the  fluids  from 
the  cavity  of  the  chest. 

The  operation  is  now  so  much  improved,  and  is  so  safe  and  simple 
and  attended  with  so  little  pain,  that  it  has  become  an  every-day 
practice,  and  an  operation  which  was  only  resorted  to  as  an  extreme 
measure  to  save  life,  is  now  admissible  whenever  the  pleural  cavity 
remains  filled  with  liquid,  after  only  a brief  trial  of  the  remedies 
assigned  to  promote  absorption. 


Lung  Fever. — Pneumonia. 

This  disease,  by  common  usage,  has  been  called  a fever;  but  by 
physicians  it  is  reckoned  as  one  of  the  inflammations.  It  is  inflamma- 
tion of  the  lungs  or  lights  ; and  whatever  fever  there  may  be  results 
entirely  from  this  local  inflammation. 

For  the  purpose  of  more  clearly  describing  this  complaint,  it  is 
found  convenient  to  divide  it  into  three  stages,  or  degrees  of  progress. 

First  Stage.  — This  is  called  the  stage  of  engorgement.  The  lungs 
during  this  stage  are  engorged  or  crowded  with  blood.  If  we  could 
inspect  them,  we  should  find  the  inflamed  portioji  redder.,  thicker.,  and 
heavier  than  usual.  We  should  find  them  weaker,  that  is,  more 
easily  torn  than  in  the  natural  state ; with  less  air  in  them,  and  con- 
sequently crackling  less  upon  pressure,  — yet  not  entirely  destitute 
of  air  and  crackling,  and  not  so  heavy  as  to  sink  in  water.  Eapping 
upon  the  chest  at  this  period  gives  out  a flatter,  duller,  or  less  hollow 
sound  than  usual.  On  applying  the  stethoscope,  we  hear  less  of  the 
natural  rustling  sound  of  health ; and,  either  mingling  with,  or  over- 
coming it,  we  hear  a minute  crackling  sound,  as  the  air  passes  in  and 
out  in  breathing. 

This  crackling  has  been  compared  to  that  produced  by  fine  salt 
thrown  upon  red-hot  coals ; or  by  that  of  rubbing  a lock  of  fine  hair 
between  the  thumb  and  finger  near  the  ear.  It  is  caused  by  small 
bubbles  of  air  being  forced  along  the  moist  and  sticky  sides  of  the 
small  tubes  and  air-cells.  It  is  heard  only  while  the  breath  is  being 
drawn  in. 

Second  Stage.  — If  the  inflammation  advances  to  the  second  stage, 
the  swelling  of  the  diseased  lung  increases  so  as  to  force  out  the  air 
entirely,  and  it  becomes  solid.,  and  wholly  useless  for  the  purpose  of 
breathing.  In  solidity  and  general  appearance,  it  resembles  a piece 
of  liver.  Hence  it  is  said  to  be  hepatized,  or  liverized ; and  this  is 
called  the  stage  of  hepatization. 

As  the  lung  grows  more  solid,  its  vitality  and  strength  diminish; 
it  is  not  near  as  strong  as  a piece  of  healthy  liver,  though  it  looks 
like  it;  it  is  soft  and  easily  broken;  indeed  it  seems  to  be  in  a state 
of  commencing  decay  or  rottenness.  Hence  some  writers,  in  order 
to  be  more  precisely  correct,  cal)  this  the  stage  of  red  softening. 


Lungs  and  Their  Diseases. 


State  of  the  Lungs  in  Pleuro- 
Pneumonia. 


A portion  of  the  tissue  of  the  Lungs 
showing  Blood  Vessels,  Capillaries  and 
Air  Tubes — magnified  50  diameters. 


Consolidation  of  Lurtgs  in  Vesicular 
Pneumonia. 


For  healthy  condition  of  Lungs  see  Manikin. 


DISEASES  OF  THE  CHEST. 


297 


With  increased  solidity,  there  is  of  course  increased  dullness  on 
percussion.  When  the  stethoscope  is  applied  to  the  chest,  we  hear 
no  sound  of  air  passing  into  and  out  of  the  diseased  lung ; no  natural 
rustling,  or  minute  crackling ; but  in  their  stead,  we  have  a kind  of 
whistling,  produced  by  the  air  passing  back  and  forth  in  the  wind- 
pipe and  its  branches,  but  finding  no  entrance  into  the  solidified  air- 
cells.  The  breathing  sometimes  sounds  like  a sort  of  puff,  — owing 
to  the  column  of  air  rebounding  when  refused  admission  to  the 
closed-up  cells. 

The  general  symptoms  now  increase  in  severity.  There  is  greater 
difficulty  of  breathing;  the  phlegm  is  more  gluey;  perhaps  some 
delirium  shows  itself ; and  the  patient  grows  weaker. 

Third  Stage.  — At  this  period,  the  lung  changes  from  red  hepa- 
tization or  red  softening  to  gray  hepatization  or  gray  softening,  and 
matter  is  now  found  diffused  through  its  whole  substance.  The 
percussion  sounds  are  much  the  same  as  in  the  second  stage.  On 
listening,  we  hear  more  of  the  rattling  sound  produced  by  disturbed 
phlegm.  The  matter  raised  is  thinner,  — more  like  liquid ; and 
looks  like  prune-juice.  The  symptoms  generally  indicate  that  the 
patient  is  sinking.  Patients  may  recover  from  the  first  and  second 
stages,  but  rarely  from  the  third. 

Symptoms — For  several  days  before  the  disease  is  pronounced 
enough  to  make  the  patient  appear  very  sick  there  is  a general  discomv 
fort  of  the  principal  air  passages,  especially  the  nose  jand  throat,  in 
fact,  a great  many  cases  of  pneumonia  follow  a so-called  cold,  which 
has  been  present  for  two  or  three  weeks.  In  others,  and  in  this 
disease  perhaps  the  first  symptom  to  be  noticed  is  a chill,  mild  or 
severe,  which  has  no  influence  upon  the  severity  of  the  disease  that 
is  to  follow.  Following  this  chill  comes  the  fever  and  usually  the 
so-called  pluritic  pain  over  some  portion  of  either  lung,  many  times 
it  appears  to  be  over  the  nipple  of  the  side  affected,  or  it  may  appear  in 
the  lower  chest  or  even  in  the  back.  Shortness  of  breath  caused  by  the 
pain  when  a deep  inhalation  is  attempted  then  appears,  and  though  the 
pain  in  the  chest  may  diminish,  which  is  frequently  the  case,  fever  and 
shortness  of  breath  continues;  the  appetite  leaves,  thirst  appears  to  a 
greater  or  less  extent,  the  bowels  are  usually  sluggish,  the  flush  shows 
on  the  cheeks  and  a distressed,  hacking  cough,  suppressed  if  causing 
too  much  pain,  and  the  raising  of  a scanty,  dark  reddish  phlegm, 
which,  when  expectorated  into  a vessel  has  a tendency  to  stick  to 
the  sides,  and  does  not  flow  freely  hke  sahva.  The  disease  rapidly 
assumes  a severe  condition,  and  in  favorable  cases  remains  about 
the  same  for  five  to  eight  days.  During  these  days  mentioned,  the 
so-called  crisis  occurs,  which  is  the  sudden  dropping  of  the  tempera- 
ture from  102  to  104  at  which  height  it  has  been,  down  to  the  normal, 
which  is  98J  degrees.  The  respiration  during  these  times  is  rapid 
and  short.  The  sickness  of  the  patient  progressively  increases  the 


298 


DISEASES  Oi’  THE  CHEST. 


pulse  which  is  around  100  to  130.  The  mind  is  many  times  clouded, 
especially  in  children  or  those  addicted  to  liquor. 

Treatment. — It  is  well  to  understand  that  in  this  most  serious 
disease  the  best  care  and  maintenance  of  strength  is  absolutely 
required.  There  are  a certain  number  of  cases  that  will  die  m spite 
of  the  best  treatment  that  can  be  obtained,  another  number  will 
get  well  if  not  given  the  wrong  treatment  or  neglected,  but  a large 
middle  class  between  these  two  extremes  will  need  careful  treatment 
to  carry  them  through  to  recovery.  There  can  be  no  absolute  routine 
treatment  in  pneumonia,  as  the  condition  of  the  patient  will  demand 
how  much  stimulation  is  needed  and  what  degree  of  lung  tissue  is 
affected.  In  the  early  stages  of  pneumonia,  some  depressant  to  the 
increased  circulation  which  will  be  seen  by  the  rapid  beat  of  the 
pulse,  is  needed,  a tincture  of  aconite  or  of  veratum  viride  in  one 
drop  doses  repeated  every  half  hour  until  five  or  eight  doses  have 
been  given.  Although  the  temperature  will  be  increased  at  this 
time,  a hot  mustard  foot  bath  will  help  the  aconite  in  its  action  and 
relieve  temporarily  the  congestion  of  the  lung.  If  violent  pain  in 
the  chest,  due  to  pleurisy  is  present,  small  doses  of  Dover’s  powder 
which  may  be  obtained  at  drug  stores  and  which  consists  of  ipecac 
which  IS  a sweat  producer,  and  morphine  which  is  a pain  quieter, 
and  the  combination  of  these  two,  act  most  happily  upon  the  system 
in  this  condition.  Thus  5 to  10  grains  of  Dover’s  powders  repeated 
it  the  pain  continues,  every  three  or  four  hours  will  often  give  great 
relief.  This  remedy  must  be  used  only  during  the  first  two  or  three 
days,  as  later  on  they  will  only  tend  to  further  depress  the  heart, 
which  may  by  this  time  be  showing  the  effect  of  the  disease.  It  will 
now  be  necessary  to  see  that  the  eliminating  organs  of  the  body,  such 
as  the  bowels,  the  kidneys  and  the  lungs  are  kept  in  a state  of  active 
work,  an  expectorant  such  as  the  prescription  recommended  under 
bronchitis  consisting  of  chloride  of  ammonia,  citrate  of  potash  and 
licorice  mixture  will  enable  the  patient  to  raise  the  phlegm  and  the 
citrate  of  potash  will  exert  a favorable  action  of  the  kidneys. 
It  then  remains  for  us  to  keep  the  heart  in  as  good  condition  as 
possible,  care  being  taken  not  to  over-stimulate  as  the  chances  are 
good  for  all  the  stimulants  we  possess  to  be  needed  before  the  patient 
is  through  the  crisis.  This  is  done  by  the  use  of  strychnia,  the 
most  favorable  and  digitalis  and  alcohol  in  the  form  of  whiskey  and 
brandy  in  the  order  named.  Strychnia  may  be  given  on  the  second 
and  third  days,  or  if  not  needed  then,  when  the  acceleration  of  the 
pulse  to  above  110  renders  it  necessary.  The  dosage  may  be  at  first 
1 -60  of  a gram  four  times  a day : when  this  dose  ceases  to  hold  the 
pulse  at  110  the  dose  may  be  increased  to  1-40  of  a gram  every  four 
hours,  and  even  later  again  increased  to  1-30  or  even  1-20  of  a grain, 
but  of  course,  these  later  doses  only  on  the  advice  of  the  'physician  'who  has 


diseases  of  the  chest. 


299 


taken  charge  of  the  case.  Whiskey  or  brandy  in  tablespoon  doses  for 
adult  every  four  to  six  hours  will  be  of  temporary  service  in  tiding 
the  patient  over  attacks  of  heart  failure.  Digitalis  in  the  form  of 
tincture  given  in  doses  of  10  drops  three,  four  or  five  times  during 
twenty-four  hours  may  be  needed  after  the  third,  fourth  or  fifth  days. 
The  fever  will  often  rise  to  103  or  104  degrees  and  remain  at  this 
point,  but  as  the  disease  will  turn  sometime  between  the  fifth  and 
eighth  or  ninth  days  we  do  not  have  to  use  strenuous  measures  to 
reduce  the  fever  unless  the  patient  is  very  nervous  or  delirious.  In 
this  latter  case  tepid  or  cool  water  sponging  will  often  relieve  the  ner- 
vous troubles  by  reducing  the  fever  and  enabling  the  patient  to  sleep 
without  artificial  aid.  A jacket  made  of  sheet-wadding  and  kept  about 
the  chest  is  a good  precaution  if  constant  care  of  a nurse  is  not  given. 
This  will  often  tend  to  reduce  congestion  and  surely  keeps  the  chest 
from  exposure  to  changes  in  temperature,  should  the  patient  throw 
off  the  clothes.  In  emergencies  which  may  occur  at  any  time  during 
the  course  of  the  disease  and  to  be  watched  for  especially  at  the  crisis 
or  turn  of  the  disease,  the  aromatic  spirits  of  ammonia  in  half  tea- 
spoonful^  doses  diluted  with  water  may  be  given  every  hour  for  the 
stimulating  effect.  Oxygen  is  often  of  value  though  many  times  used 
without  effect.  It  will  quiet  labored  breathing  to  some  extent  and 
supply  the  blood  with  a necessary  article  which  the  consolidation  in 
the  lung  IS  withholding  from  it.  As  soon  as  possible  withdraw  what 
unnecessary  stimulation  is  being  given  and  through  the  convalescence 
give  the  expectorant  mixture  and  nourish  well  with  eggs,  broth,  milk 
and  hght  but  concentrated  articles  of  diet.  ’ 

Typhoid  Lung  Fever.  — Typhoid  Pneumonia. 

This  is  an  inflammation  of  the  lungs,  differing  from  the  preceding 
only  in  the  character  of  the  fever  attending  it,  which  is  of  a low, 
typhoid  character.  The  disease,  like  typhoid  fever,  is  characterized 
by  great  debility  and  prostration. 

Symptoms.  — These  are  a combination  of  the  symptoms  of  pneu- 
monia and  of  typhoid  fever.  The  disease  begins  with  great  weari- 
ness, lassitude,  dizziness,  pain  in  the  head,  back,  and  limbs.  Soon 
there  is  much  difficulty  of  breathing,  tightness  across  the  chest,  with 
a.  dry,  short,  hacking  cough. 

As  the  disease  advances,  the  active  symptoms  pass  away ; there  is 
a dull  pain  across  the  chest ; drowsiness  is  very  apt  to  come  on,  with 
the  various  symptoms  of  sinking  peculiar  to  typhoid  fever.  The 
skin  is  harsh  and  dry,  the  temperature  uneven,  the  tip  and  edge  of 
the  tongue  red,  and  the  middle  covered  with  a yellow  or  brown  fur. 
The  bowels  are  tender,  swollen,  and  drum-head  like ; while  there  is 
often  a diarrhoea,  — the  discharges  having  a dirty-yellow  color. 

Treatment.  — This  should  be  like  the  treatment  of  pneumonia 
and  typhoid  fever  united. 


300 


DISEASES  OF  THE  CHEST. 


Great  care  must  be  taken  not  to  use  reducing  remedies.  While 
active  purging  must  not  be  used,  yet,  if  there  are  symptoms  of  an 
inactive  state  of  the  bowels,  podophyllin  and  leptandrin  (34),  (39), 
may  be  employed  with  advantage. 

When  there  are  symptoms  of  great  depression,  use  tonics  (46), 
(48),  (50),  (53),  (60),  (64),  (67),  (73),  taking  care  to  keep  the 
cough  loose  by  flaxseed,  slippery  elm,  and  marshmallow  tea,  and  by 
some  external  irritant. 

Broncho-Pneumonia. 

This  is  an  infectious  inflammation,  characterized  by  an  exudation 
from  the  blood-vessels,  the  formation  of  new  connective  tissue,  and 
the  growth  of  bacteria.  The  disease  involves  the  walls  of  the  bronchi 
and  the  air-spaces  surrounding  the  inflamed  tubes.  It  is  frequently 
called  capillary  bronchitis  and  catarrhal  pneumonia.  It  is  the  ordi- 
nary pneumonia  of  children,  and  is  frequently  seen  in  young  people. 

It  comes  on  primarily,  but  is  often  secondary  to  measles,  whooping- 
cough,  etc. 

Symptoms.  — In  the  very  young,  the  only  symptoms  are  fever, 
prostration,  and  rapid  breathing.  There  is  no  cough,  no  physical 
signs,  but  the  disease  is,  almost  always,  fatal  within  a few  days’  time. 

There  is  a great  difference  in  the  invasion  of  the  disease  in  dif- 
ferent cases,  the  severer  cases  being  ushered  in  by  one  or  more  con- 
vulsions, by  rapid  rise  of  temperature,  vomiting,  difficulty  in  breathing, 
and  delirium;  the  milder  cases  beginning  with  lower  temperature, 
moderate  prostration  and  shortness  of  breath. 

The  height  of  the  temperature  is,  as  a rule,  in  proportion  to  the 
severity  of  the  disease.  Temperatures  of  105°  and  over  are  usually 
fatal.  The  pulse  reaches  150  to  170  in  adults,  and  even  higher  in 
clhldren,  — so  high,  in  fact,  that  it  cannot  be  taken.  The  respiration 
varies  from  40  to  80.  Sleeplessness,  restlessness,  and  even  delirium 
are  frequently  present.  The  face  is  flushed,  the  tongue  coated,  and 
oftentimes  diarrhcea  and  vomiting  occur.  Cough  is  usually  present, 
and  in  the  young  the  sputum  is  swallowed.  The  urine  is  frequently 
albuminous  and  contains  casts. 

Between  the  second  and  fifth  days  the  signs  of  consoHdation  and 
pleurisy  appear,  i.  e.,  dullness  on  percussion,  bronchial  breathing  and 
bronchophony  with  crepitant  rattles. 

The  duration  of  the  disease  in  children  varies : of  the  fatal  cases 
the  majority  die  within  the  first  fortnight.  The  cases  which  recover 
vary  from  one  to  three  weeks,  though  many  persist  for  six  and  eight 
weeks.  The  softening  and  absorption  which  occurs  in  all  pneumo- 
nias that  recover  occupy  a much  longer  jreriod  in  broncho-pneumo- 
nia than  in  lobar  pneumonia. 

Many  cases  of  broncho-pneumonia  are  complicated  by  cerebral 
symptoms  of  convulsions,  delirium,  stupor,  vomiting,  etc.,  even  before 


4 


DISEASES  OF  THE  CHEST. 


301 


any  marked  lesions  in  the  lungs  appear;  as  these  subside  the  lung 
symptoms  appear.  Many  cases  are  protracted  for  a long  time,  and 
though  they  may  terminate  favorably  at  last,  yet  they  are  apt  to  run 
into  a chronic  hardening  of  the  lung  which  lasts  for  years ; or  they 
recover  with  a permanent  consolidation  of  the  lung.  Some  die  of 
exhaustion. 

Treatment.  The  use  of  hot  fomentations  and  poultices  over  the 
chest  and  the  administration  of  small  doses  of  ipecac  and  aconite  at 
short  intervals  soothe  the  bronchitis  and  pain. 

For  the  cerebral  symptoms,  phenacetin  and  the  bromides  are  very 
useful.  Aconite  and  digitalis  are  usually  employed  when  the  pneu- 
monia stage  comes  on.  As  a rule  stimulants  are  not  required  in 
children,  in  whcfm  the  disease  most  frequently  occurs. 

In  convalesence,  iron,  quinine,  cod-liver  oil,  oxygen  and  a change 
of  air  are  to  be  recommended.  ° 

Other  Forms  of  Lung  Inflammation. 

Of  the  various  other  forms  of  lung  inflammation  which  occur 
mention  may  be  made  of  pneumonia  dependent  on  Heart  Disease  i 
Interstitial  Pneumonia,  or  the  formation  of  new  connective  tissue 
and  obliteration  of  the  air-spaces ; Tubercular  Pneumonia,  which  is 
caused  by  the  presence  of  tubercle  bacilli;  Acute  and  Chronic  Mi- 
lia^  Tuberculosis,  characterized  by  the  presence  of  numerous  minute 
nodules  called  miliary  tubercles;  Acute  and  Chronic  Tubercular 
Consumption  ; Gangrene  of  the  Lung,  where  a portion  of  the  lung 
has  lost  its  vitality  and  the  germs  of  putrefaction  have  entered. 

Asthma. 

Asthma  may  be  defined  to  be  great  difficulty  of  drawing  in  the 
breath,  — coming  on  suddenly,  sometimes  gradually,  — accompanied 
with  a sense  of  extreme  suffocation,  and  a desire  for  fresh  air ; con- 
tinuing for  a longer  or  shorter  period,  and  then  passing  away,  and 
leaving  the  patient  a period  of  comparatively  easy  respiration. 

Symptoms.  — There  are  sometimes  no  premonitory  symptoms 
■he  attack  coming  on  suddenly,  and  without  warning  5 but  more  fre^ 
quently  there  are,  for  some  days  before  the  onset,  loss  of  appetite, 
tiatulence,  belching  of  wind,  irritability,  languor,  chilliness,  oppres- 
sion, and  drowsiness.  The  hard  breathing  generally  makes  its 
appearance  in  the  night,  — quite  often  at  three  or  four  o’clock  in 
the  morning,  when  the  nervous  system  is  at  its  lowest  ebb.  There 
IS  first  a sense  of  tightness,  or  stricture,  across  the  chest,  which 
seems  to  expand  with  difficulty.  The  patient  can  no  longer  remain 
lying  down;  he  rises  up,  draws  up  his  knees,  and,  leaning  forward, 
puts  his  elbows  upon  them,  and  his  head  upon  his  hands,  and  then 
s ruggles  hard  to  draw  in  his  breath ; which,  passing  in  slowly  and 


302 


DISEASES  OF  THE  CHEST. 


laboriously,  produces  a loud  wheezing  sound.  Sometimes  he  feels 
that  he  must  have  fresh  air,  and,  rushing  to  a window,  puts  his  head 
far  out,  to  catch  a stirring  breeze.  The  hands  and  feet  are  cold,  the 
face  haggard  and  distressed,  — sometimes  a little  red  and  swollen, 
but  more  generally  pale  and  shrunk,  — the  body  wet  with  perspira- 
tion, the  pulse  irregular,  feeble,  and  small,  though  sometimes  not 
disturbed.  These  symptoms  continue  for  some  hours,  more  or  less, 
when  the  breathing  becomes  more  easy,  and  there  is  a little  phlegm 
raised,  sometimes  considerable.  This  cessation  of  difficult  breathing 
may  be  complete,  or  only  partial ; and  lasts  for  a longer  or  shorter 
period,  when  the  attack  again  recurs. 

Causes.  — It  is  well  known  that  Asthma  has  its  cause  mainly  in 
the  nervous  system.  The  air-tubes  are  encircled  with  a series  of 
little  bundles  of  fibres,  which  are,  in  fact,  muscles,  and  like  all  other 
muscles  have  the  power  of  contracting  or  shortening  themselves. 
These  muscles,  too,  like  all  others,  have  nerves  distributed  to 
them ; and  when  these  nerves  become  diseased  or  irritable,  they  will 
become  disturbed  on  certain  occasions,  and  cause  these  small,  circu- 
lar puckering  strings  to  contract  and  close  up  the  air-tubes  near 
their  terminations,  very  much  as  the  puckering-string  closes  the 
mouth  of  the  work-bag,  so  that  very  little  air  can  pass  into  the  air- 
cells,  and  that  little  with  great  difficulty  and  slowness.  When  these 
contractions  take  place,  and  the  air  is  thus  shut  off,  the  result  is  a fit  of 
asthma.  This  disease  may  be  brought  on  by  any  of  those  states  of 
the  atmosphere  which  disturb  or  irritate  the  bronchial  surfaces,  or  by 
any  of  the  numerous  causes  which  mysteriously  unbalance  the 
nervous  system.  A fit  may  be  brought  on  by  whatever  disturbs  the 
mind. 

In  addition  to  this  cause  which  is  known  as  the  bronchial  type  of 
asthma  there  are  the  cardiac  and  iieiihritic  types.  The  so-called 
cardiac  asthma,  in  the  early  stages  is  perhaps  more  amenable  to  treat- 
ment than  the  bronchial  type  but  its  course  would  not  be  effected 
by  the  drugs  given  for  the  latter  type  and  appropriate  remedies  for 
the  heart  must  be  given.  In  the  nephritic  type  the  asthma  is  due 
to  the  retention  in  the  system  of  the  poison  which  is  prevented 
from  passing  out  of  the  body  in  the  urine  because  of  disease  of  the 
kidneys. 

Treatment.  — The  disease  has  been  regarded  as  extremely  diffi- 
cult of  cure.  There  are  certain  remedies,  however,  which  have  a 
remarkable  control  over  it,  and,  if  skilfully  used,  will  frequently 
bring  it  to  a complete  termination,  and,  even  in  the  worst  cases,  to  a 
state  of  very  great  mitigation  and  improvement. 

Inhalation.  — The  most  important  and  certain  remedy  is  the  use 
of  the  Alterative  Inhalant,  described  on  page  273.  I have  with  this 
article  alone  effected  some  surprising  cures ; yet  it  is  well  to  combine 


DISEASES  OF  THE  CHEST.  303 

other  treatment  with  it.  I have  had  several  cases  of  a most  distress- 
ing character,  — the  attacks  continuing  night  and  day,  — in  which 
the  inhalation,  judiciously  administered,  has  caused  the  disappearance 
of  the  complaint  within  twenty-four  hours,  and  in  which  no  return  of 
suffering  has  occurred  for  several  weeks,  and  then  only  in  a modified 
form.  This  remedy  should  be  used  four  or  five  times  a day. 

Iodide  of  potassium  is  a most  valuable  internal  remedy  in  this 
complaint;  indeed,  in  a certain  sense,  it  is  almost  a specific.  It 
should  be  used  (prescriptions  101,  138,  140,  151)  at  the  same  time 
with  the  inhalation.  The  following  preparation  is  a very  good 
remedy  for  this  disease : Ethereal  tincture  of  lobelia,  two  ounces ; 
tincture  of  asafoetida,  one  ounce ; grindelia,  one  ounce ; iodide  of 
potassiurh,  two  ounces ; simple  syrup,  four  ounces.  Mix.  Dose, 
from  a teaspoonful  to  a tablespoonful,  every  hour  or  two. 

Several  other  remedies  are  used  for  asthma,  with  more  or  less 
success,  such  as  electro-magnetism,  smoking  stramonium  leaves, 
burning  paper  dipped  in  a strong  solution  of  nitrate  of  potash,  and 
inhaling  the  smoke,  etc.,  ■ — but  none  of  these  have  as  much  value  as 
the  two  remedies  first  named. 

For  the  cardiac  type  strychnia,  digitalis,  spartine,  strophanthus  and 
cocaine  in  appropriate  dosage  must  be  given  to  effect  an  improve- 
ment. For  the  kidney  type  relief  of  the  system  by  other  channels 
than  the  kidneys,  until  they  are  in  better  working  order  will  be 
necessary.  This  can  be  accomplished  by  the  use  of  saline  cathartics 
such  as  one  or  two  teaspoonfuls  of  epsom  salts  diluted  with  water, 
given  often  enough  to  cause  two  or  three  watery  discharges  during 
twenty-four  hours.  In  addition  to  this  sweating  of  the  skin  by 
means  of  hot  lemonade  or  small  doses  of  Dover’s  powders  in  hot 
drinks  may  be  given. 

In  as  grave  a complaint  as  a severe  case  of  asthma,  it  is  always 
well  to  seek  the  aid  of  a physician. 

Hay= Asthma.  — Hay=Fever. 

This  is  a very  troublesome  complaint,  which  seems  to  combine 
the  peculiarities  both  of  asthma  and  of  influenza.  Fortunately,  it 
attacks  but  few  persons,  and  those  only  at  particular  seasons  of  the 
year,  — namely,  while  hay  is  in  blossom,  and  during  hay-making. 

Symptoms.  — These  are  a combination  of  the  symptoms  of  the 
two  diseases  above  named.  There  is  great  irritation  of  the  eyes, 
with  sneezing,  and  a free  discharge  from  the  nose.  There  is 
tightness  across  the  chest,  difficulty  of  breathing,  and  a pricking 
sensation  in  the  throat.  These  symptoms  often  appear  in  great 
severity,  making  the  complaint  a really  distressing  one. 

Cause.  — This  disorder  appears  to  have  but  one  cause,  — namely, 
some  sort  of  emanations  from  the  grasses,  flowers,  etc.,  while  in 
blossom ; which  emanations  come  in  contact  with  the  mucous  lining 
of  the  eyes,  nose,  and  throat,  producing  very  great  and  teasing  irri- 
tation. 


304 


DISEASES  OF  THE  CHEST. 

Treatment.  — One  of  the  best  remedies  for  this  troublesome  com- 
plaint is  to  avoid  the  cause,  by  removing,  during  the  flowering  and 
haying  season,  to  some  large  city,  or,  still  better,  close  down  to  the 
seashore,  where  flowers  and  hay  do  not  grow. 

Of  medicines,  the  tincture  of  lobelia,  taken  in  moderate  doses,  is 
a very  good  remedy.  Quinine  and  iron,  given  in  combination  (75), 
are  valuable  preparations.  Strychnine  and  nux  vomica,  in  connec- 
tion with  iron  or  otherwise  (316),  (83),  (84),  (85),  (86),  (95),  are 
very  useful.  Iodide  of  potassium  (101),  (138),  (140),  is  also  worth 
a trial.  Another  very  good  remedy  is  the  chloride  of  lime,  or  the 
chloride  of  soda,  placed  in  saucers  about  the  sleeping-room.  Pieces 
of  cotton  cloth  may  also  be  dipped  in  one  of  these  solutions,  and 
hung  about  the  apartments  of  the  house.  The  hands  and  face  may 
likewise  be  washed,  once  or  twice  a day,  in  a weak  solution. 

The  oxide  of  zinc  and  the  extract  of  nux  vomica,  made  into  pills, 
two  grains  of  the  zinc  to  half  a grain  of  the  extract  to  each  pill,  and 
one  pill  taken  morning  and  evening,  should  not  be  forgotten. 

Of  late  cocaine,  painted  by  means  of  a camel’s  hair  brush  on  the 
mucous  membrane  of  the  nose,  has  been  used  to  check  a paroxyism 
and  mitigate  the  disease. 

The  following  formula  is  the  most  efficacious  of  this  class  of 
remedies  and  should  be  painted  onto  the  nasal  mucous  membrane  as 
high  up  as  possible ; its  use  may  be  repeated  several  times  till  the 
membrane  becomes  numb. 


Cocaine 12  gr. 

Antifebrin 25  gr. 

Alcohol 1 dr. 


Simple  Elixir  ...........  3 dr. 

Mix  and  shake  before  using. 


DISEASES  of  the  HEART 


HEART  DISEASES. 

(Also  see  Anatomy  of  Organs  of  Circulation.) 


Life  rests  upon  a tripod,  — the  brain,  the  lungs,  and  the  heart. 
These  are  equally  important  to  its  well-being  and  continuance. 

In  substance,  the  human  heart  is  a bundle  of  muscles,  so  put  to- 
gether as  to  bear  the  greatest  possible  amount  of  work.  In  size, 
shape,  and  look,  it  is  much  like  the  heart  of  the  hog.  I wish  it 
never  had  a likeness  to  it  in  its  moral  nature. 

The  heart  is  enclosed  in  a case  or  sac,  called  the  pericardium.  It 
lies  between  the  two  lungs,  a little  to  the  left  side  of  the  chest.  Its 
point  is  under  the  sixth  rib  on  the  left  side,  and  its  lower  surface 
rests  on  the  diaphragm,  — a horizontal  partition  between  the  chest 
and  belly. 

The  heart  is  double.  It  has  four  cavities,  — two  for  receiving  the 
blood,  which  are  called  auricles^  and  two  for  driving  it  out,  called 
veyitricles. 

The  venous,  or  dark  blood,  is  brought  from  all  parts  below,  and 
emptied  into  the  right  auricle  through  the  ascending  vena  cava,  and 
from  all  parts  from  above,  and  pour  into  the  same  cavity  through 
the  descending  vena  cava.  From  this  it  passes  into  the  right  ventri- 
cle, which  contracts,  and  forces  it  through  the  pulmonary  artery  into 
the  lungs,  where  it  becomes  red,  and  passes  into  the  left  auricle 
through  the  jjulmonary  vein,  thence  into  the  left  ventricle,  which 
contracts,  and  throws  it  out  through  the  great  aorta  to  all  parts  of 
the  body.  Fig.  95  gives  a good  idea  of  the  circulation  through  the 
heart  and  lungs. 

The  heart  is  divided  into  two  sides,  which  are  separated  from  each 
other  by  a muscular  partition,  — each  side  having  an  auricle  and  a 
ventricle. 

The  auricles  have  comparatively  thin  walls,  as  they  are  only  used 
for  reservoirs.  The  walls  of  the  ventricles  are  much  thicker,  being 
used,  — particularly  that  of  the  left  side,  • — for  forcing  the  blood 
over  a large  surface. 

Between  the  auricle  and  ventricle  on  the  right  side,  are  three  folds 
of  triangular  membrane,  called  the  tricuspid  valves.  Between  the 
auricle  and  ventricle  on  the  left  side,  are  three  valves,  called  mitral. 

At  the  beginning  of  the  pidmonary  artery,  and  the  aorta,  are  three 
half-moon  shaped  folds  of  membrane,  called  semilunar  valves. 

306  • 


HEART  DISEASES. 


307 


The  office  of  all  these  valves  is,  to  close  after  the  blood  has  gone 
through,  and  prevent  its  flowing  back  while  the  cavity  is  being  again 
filled.  They  do  the  same  duty,  in  fact,  as  the  valves  of  a pump. 

Through  this  heart,  thus  constructed,  all  the  blood  in  the  body, — 
about  twenty-eight  pounds,  — passes  once  in  about  one  minute  and  a 
half.  This  is  rapid  work;  and  when  we  consider  that  the  heart 
works  in  this  way  through  the  whole  life,  resting  not,  day  or  night, 
we  cannot  wonder  that  it  gets  out  of  order. 


Fig.  95. 


The  whole  heart  is  seldom  affected.  The  left  side  is  more  liable 
to  disease  than  the  right. 

Impulse  of  the  Heart. 

The  ear,  when  placed  over  the  heart,  feels,  at  each  beat,  a slight 
shock.  This  is  felt  at  the  same  time  the  first  sound  is  heard.  This 
impulse  is  caused  by  the  apex  or  point  of  the  heart  being  thrown  up 
against  the  ribs  by  the  contraction  of  the  ventricles.  It  is  felt  best 
between  the  cartilages  *of  the  fifth  and  sixth  ribs  on  the  left  side. 

The  Sounds  of  the  Heart. 

On  applying  the  ear  to  the  chest  just  over  the  heart,  two  sounds 
are  heard.  The  first  one  is  dull  and  slightly  prolonged ; the  second 
is  a shorter  and  smarter  sound,  having  a sort  of  clack.  These  occur 
in  pretty  rapid  succession,  and  then  comes  a brief  interval.  And  this 
round  of  action,  first  a long  and  dull  sound,  then  a short  and  smart 
one,  and  then  an  interval,  — called  the  heart’s  rhythm,  — is  repeated 
continually.  If  the  space  of  time  occupied  by  the  rhythm  be  divided 


308 


HEART  DISEASES. 


into  five  parts,  the  first  sound  will  take  about  two  parts,  the  second 
one,  and  the  interval  of  repose,  the  remaining  two.  The  first  sound 
is  heard  about  the  time  of  the  contraction  of  the  ventricles,  and  is 
therefore  called  the  systolic  sound ; the  second  is  synchronous  with 
the  opening  of  the  ventricles,  and  is  called  the  diastolic  sound.  The 
syllables  too-to  — too-to,  very  fairly  represent  the  two  sounds  of  the 
heart.  These  sounds  are  heard  over  the  largest  space  in  lean 
persons. 

Percussion  Sounds. 

If  the  ends  of  the  fingers  be  struck  upon  the  chest  over  the  heart, 
a dull  sound  will  be  heard  over  a space  from  one  and  a half  to  two 
inches  square,  — beginning  at  the  fourth  rib  on  the  left  side,  and  ex- 
tending down  nearly  to  the  sixth.  The  dullness  is  diminished  by 
lying  upon  the  back,  and  increased  by  leaning  forward,  and  by  taking 
a full  breath.  The  deadness  of  sound  is  caused  by  the  heart  being 
a partially  solid  body.  The  lungs  which  surround  it  yield  a clear 
sound. 

If  a solid  substance,  as  large  as  the  heart,  were  placed  on  the  in- 
side of  a drum,  against  the  head,  only  a dead  sound  would  be  ob- 
tained by  striking  on  that  spot ; everywhere  else,  the  sound  would 
be  louder. 

Altered  Sounds  of  the  Heart.  * 

These  sounds  are  changed  by  disease  in  a variety  of  ways,  both  as 
to  their  character  and  duration.  One  or  both  sounds  may  be  turned 
into  a noise  like  the  blowing  of  a pair  of  bellows.  This  is  called  the 
bellows  sound.  When  this  sound  is  very  harsh,  it  may  become  like 
the  noise  of  a rasp,  or  file,  or  saw.  These  altered  sounds  are  all  pro- 
duced by  an  altered  condition  of  the  valvular  passages  through 
which  the  blood  passes.  If  you  build  an  aqueduct  of  equal  dimen- 
sions throughout,  and  smooth  on  the  inside,  you  may  send  a certain 
volume  of  water  through,  at  a given  speed,  without  noise.  But  if 
you  make  sudden  contractions  in  the  aqueduct,  or  allow  large  stones 
to  project  into  it,  and  then  attempt  to  send  through  the  same  body 
of  water,  at  the  same  rate  of  speed,  you  will  hear  all  sorts  of  noises. 

Enlargement  or  Hypertrophy  of  the  Ventricles. 

This  is  simpl}^  a thickening,  or  an  increase  of  bulk,  in  the  walls 
of  the  ventricles.  The  muscles  composing  the  walls  of  one  or  both 
of  these  cavities  grow  thick  and  large. 

Physical  Signs.  — Impulse  stronger  than  natural.  When  consid- 
erable, it  is  accompanied  with  a lifting  and  heaving  of  the  parts. 
Dull  sound  on  percussion  over  a larger  space.  First  sound  of  heart 
prolonged;  second  sound  feeble.  The  interval  of  silence,  shorter 
than  natural.  In  bad  cases,  the  second  sound  is  nearly  extinguished. 


HEART  DISEASES. 


3(W 

General  Symptoms. — Hypertrophy  of  left  ventricle  gives  a strong, 
prolonged,  and  tense  pulse.  Palpitation  more  constant  than  in  any 
other  disease  of  the  heart.  In  advanced  stages,  the  patient  is  easily 
out  of  breath.  There  is  a rush  of  blood  to  the  head  on  making  exer- 
tion or  stooping,  with  more  or  less  throbbing  and  lancinating  head- 
aches, which  are  aggravated  by  suddenly  Ijing  down  or  rising  up. 
There  are  vertigo,  ringing  in  the  ears,  sparks  of  light  and  other  illu- 
sions before  the  eyes  ; also  a purplish,  violet  or  livid  color  upon  the 
cheeks,  nose,  and  lips.  In  many  cases  there  is  a dull,  severe  aching 
pain  in  the  region  of  the  heart,  and  extending  towards  the  shoulder 
and  the  inside  of  the  arm. 

When  the  right  ventricle  is  enlarged,  there  is  a swelling  of  the  ex- 
ternal jugular  veins. 

Causes.  — The  walls  of  the  heart  are  thickened  by  overwork.,  in  the 
same  way  that  the  blacksmith’s  arm  is  made  muscular  and  large.  All 
muscles  grow  in  the  same  way.  More  action  sends  more  blood  to 
them,  and  this  causes  an  increase  of  nutrition. 

Whatever  interposes  an  obstacle  to  the  passage  of  the  blood  through 
the  valvular  openings,  will  cause  the  ventricles  which  force  it  through 
to  work  harder.  Hence,  obstructions  in  the  semilunar  valves  cause 
hypertrophy  of  the  ventricles. 

Any  excitement  of  the  mind,  or  any  great  exertion,  which  causes 
the  heart  to  beat  harder  and  faster,  if  it  be  often  repeated,  will  induce 
a thickening  of  the  ventricles. 

Treatment. — First,  remove,  as  far  as  possible,  all  causes  of  excite- 
ment which  produce  palpitation.  If  the  head  is  much  affected,  apply 
wet  cups  to  the  back  of  the  neck.  The  same  may  be  applied  over 
the  heart.  This  will  generally  improve  the  symptoms  at  once.  A 
blister  placed  over  the  heart  will  likewise  make  a favorable  impres- 
sion. 

The  meals  should  be  taken  at  regular  intervals,  and  should  be  very 
light.  The  food  should  be  plain  and  simple,  and  composed  much 
more  of  vegetable  than  of  animal  food.  In  fact,  the  diet  should  be 
so  spare  as  slightly  to  reduce  the  strength. 

The  patient  should  be  careful  never  to  take  violent  exercise,  or, 
indeed  to  be  in  a hurry  about  anything.  In  bad  cases,  walking  up 
hill,  or  against  a strong  wind,  is  often  out  of  the  question,  and  must 
in  any  case  be  attempted  with  great  caution.  Staircases  are  to  be 
shunned  as  enemies.  An  attempt  to  run,  even  to  avoid  being  left  by 
the  cars,  might,  in  some  cases,  prove  immediately  fatal.  Carriage- 
riding  is  not  objectionable. 

The  passions  must  be  held  in  the  most  thorough  subjection.  Ex- 
citements of  all  sorts  are  dangerous,  and  must  be  avoided. 

For  the  first  week  or  two  of  treatment,  active  purgatives  will  be 
useful.  For  this  purpose,  epsom  salts  and  senna  will  answer  a good 
purpose,  and  should  be  used  so  as  to  procure  two  or  three  watery 
stools  a day. 


310 


HEART  DISEASES. 


In  addition  to  this,  some  sedative  to  lessen  the  force  of  the  heart’s 
action  is  generally  needed,  especially  when  there  is  considerable 
palpitation.  For  this  purpose,  tincture  of  Tblack  cohosh,  and  tincture 
of  scullcap,  or  the  former  with  tincture  of  digitalis  (285),  (94),  are 
quite  useful.  Three  to  ten  drops  of  tincture  of  the  American  helle- 
bore (veratrum  viride)  Avill  reduce  the  action  of  the  heart  perhaps 
more  effectually  than  any  other  medicine,  for  a few  days  or  weeks. 

Dilatation  of  the  Ventricles. 

The  several  cavities  of  the  heart  hold  about  one  and  a half  ounces 
each.  Dilatation  is  simply  an  enlargement  of  these  cavities,  so  that 
they  will  hold  more.  And  this  increase  in  the  size  of  the  cavity  in 
simple  dilatation  is  generally  at  the  cost  of  the  walls,  which  are  made 
thinner  and  weaker, — just  as  the  walls  of  a bladder  are  made  tliinner 
by  blowing  into  it  and  increasing  its  internal  dimensions. 

Physical  Signs.  — Impulse  more  abrupt,  and  less  marked  than  nat- 
ural. Dull  sound  on  percussion  commensurate  in  extent  with  the 
dilatation.  The  first  beat  of  the  heart,  clearer,  louder,  and  shorter 
than  natural,  and  more  nearly  resembling  the  second. 

General  Symptoms.  — Difficulty  of  breathing;  terrific  dreams; 
starting  from  sleep ; swelling  of  the  feet  and  legs  ; purple,  violet,  or 
blue  color  of  the  cheeks,  nose,  lips,  and  especially  around  the  eyes ; 
feeble  and  oppressed  palpitation ; various  disturbances  in  the  head ; 
bleeding  from  the  nose,  stomach,  bowels,  and  womb ; and  frequently 
enlargement  of  tlie  liver. 

Explanations.  — The  first  sound  of  the  heart  is  short  and  not  well 
marked,  in  consequence  of  the  muscular  walls  of  the  ventricles  in 
tins  disease  being  thin  and  in  a weakened  condition,  so  that  every 
stroke  they  make  is  short,  quick,  and  spasmodic,  instead  of  strong 
and  lifting,  as  in  hypertrophy.  For  the  same  reason,  the  impulse  is 
a brief  blow  dealt  the  walls  of  the  chest,  which  gives  a slight  shock, 
but  has  not  power  enough  to  lift  the  chest  up.  The  blow  is  quick, 
because  the  muscle  is  thin  and  can  contract  quicker  than  a thick  one. 

Dilatation,  by  thinning  the  walls  of  the  cavities,  enfeebles  the  heart, 
and  shows  us  an  obstructed  circulation.  Accordingly  the  blood  is 
not  transmitted  by  the  left  ventricle,  and  being  retained  in  the  lungs, 
it  causes  a crowded  state  of  the  vessels,  and  difficulty  of  breathing ; 
also  congestion  of  the  brain,  with  terrific  dreams,  etc.  And  this  en- 
gorgement of  the  lungs,  being  propagated  backwards  to  the  right 
heart,  great  veins,  and  all  their  ramifications,  produces  dropsy  of  the 
feet  and  legs,  discoloration  of  the  face,  passive  hemorrhages,  and  con- 
gestion of  the  brain,  liver  and  membranes.  Fig.  95  gives  an  idea  of 
how  all  this  happens. 

Treatment.  — As  in  many  other  diseases,  search  out  the  causes,  and 
remove  them.  If  it  be  obstruction  of  the  circulation  in  the  lungs  by 


INTERIOR  OF  THE  LUNGS 
DWINC  TRACHEA  AND  BRONCHIAL  TUBE 


SECTION  OF  LIVEPv 


interior  of  the  heart 


FRONT  VIEW  OF  THE  STOMACH 


HEART  DISEASES. 


311 


bronchitis  or  other  complaint,  that  needs  the  first  attention.  If  it  be 
caused  by  violent  exercise,  by  strong  emotions  of  the  mind  habitually 
indulged,  or  by  drunkenness,  or  any  other  irregularity  of  life,  these 
habits  must  be  corrected  without  delay. 

If  it  be  caused  by  organic  disease  of  the  valves  of  the  heart,  relief 
cannot  be  so  readily  obtained ; but  even  in  these  cases,  it  is  to  be 
sought  and  expected. 

The  circulation  is  to  be  kept  as  tranquil  as  possible  by  a strictly 
quiet  and  orderly  life,  and  a plain,  moderate,  unstimulating  diet.  In 
this  disease,  however,  it  should  be  more  nutritious,  and  composed  to 
a larger  extent  of  meats,  than  in  hypertrophy. 

In  some  cases  the  general  health  and  tone  of  the  system  will  need 
to  be  improved  by  bitters  (50),  (67),  (64),  (69),  (79),  mineral  acids 
(60),  iron  (269),  (61),  and  aromatics  (115).  The  compound  mix- 
ture of  iron  is  a good  preparation  when  this  mineral  is  called  for  by 
a low  state  of  the  blood. 

The  stomach  should  be  kept  in  the  best  possible  condition,  as  a 
very  small  disturbance  of  it,  even  from  acidity,  will  set  the  heart  to 
beating  very  violently. 

If  hysterical  symptoms  are  present,  the  compound  galbanum  pill, 
and  valerian  (97),  and  other  nervines  will  be  called  for. 

In  attacks  of  great  difficulty  in  breathing,  immerse  all  the  extremi- 
ties in  warm  water,  and  throw  a blanket  around  the  patient  to  pro- 
mote sweating,  — at  the  same  time  admitting  fresh  air  to  satisfy  the 
desire  for  breath.  Give  a draught,  composed  of  ether,  camphor, 
ammonia,  etc.  (135).  This  may  be  repeated  two  or  three  times,  at 
intervals  of  half  an  hour,  or  an  hour,  according  to  the  urgency  of  the 
case. 

Hypertrophy  with  Slight  Dilatation. 

This  is  one  of  the  most  common  complications  of  heart  disease. 
It  consists  both  in  a thickening  of  the  walls  of  the  heart,  and  an  en- 
largement of  the  cavities,  — the  former  being  more  marked  than  the 
latter. 

Physical  5igns.  — Both  sounds  are  louder  than  in  any  other  dis- 
ease of  the  heart,  and  are  heard  sometimes  over  the  whole  chest. 
The  impulse  is  strong  and  heaving,  with  an  abrupt  back-stroke.  In 
bad  cases,  the  whole  person,  and  even  the  bed,  is  shaken  by  it.  The 
dull  sound  on  percussion  covers  a large  space. 

General  Symptoms.  — The  same  as  those  of  the  two  diseases  of 
which  it  is  composed,  slightly  modified  by  the  action  of  each  upon 
the  other. 

Dilatation  with  Slight  Hypertrophy. 

This  is  an  enlargement  of  the  cavities  of  the  heart,  with  a slight 
thickening  of  its  walls ; the  dilatation  being  the  predominant  disease, 
or  greater  than  hypertrophy. 


312 


HEART  DISEASES. 


Physical  Signs. -—Percussion  gives  a dull  sound  in  the  region  of 
the  heart,  in  proportion  to  its  size.  The  first  beat  resembles  the  sec- 
ond. The  second  beat  is  louder  than  natural. 

The  impulse  is  a short,  quick  stroke,  which  contrasts  strongly  with 
the  slower  and  heavier  one  of  hypertrophy  and  dilatation. 

The  general  symptoms  and  the  treatment  are  a modification  of 
those  of  the  two  disease  united  in  it.  It  is,  however,  to  be  kept  in 
mind  that  the  dilatation  takes  the  lead ; and,  furnishing  the  predomi- 
nant symptoms,  is  specially  to  be  regarded  in  the  treatment. 

Aneurismal  Tumors  of  the  Heart. 

When,  from  some  obstruction  in  the  valves,  the  blood  cannot  easily 
pass  out  of  an  auricle  or  a ventricle,  its  inner  walls  may  become 
unable  to  bear  the  distending  force,  and  giving  way,  let  the  blood 
through  against  the  outer  coats,  which  stretch,  and  swell  out  into  the 
shape  of  a tumor,  — the  inside  of  the  tumor  becoming  a regular  sac. 
Such  a state  of  things  constitutes  an  aneurism  of  the  heart.  Of 
course  it  is  a very  grave  disease. 

Softening  of  the  Heart. 

In  this  disease  the  substance  of  the  heart  becomes  soft,  and  easily 
broken.  It  is  generally  the  result  of  some  form  of  inflammation. 

Physical  Signs.  — The  contractions  of  the  heart  being  weakened 
by  softening,  the  impulse  is  reduced  in  force,  and  both  beats  are 
weaker,  and  often  they  are  intermittent.  The  first  beat  becomes 
short  and  flapping,  like  the  second. 

General  Symptoms. — A quick,  feeble,  small,  and  faltering  pulse, 
great  anxiety,  and  a disposition  to  faint.  General  languor ; a sallow, 
bloodless,  withered  complexion,  with  a purple,  livid  tint  of  the  lips 
and  cheeks,  and  frequently,  general  dropsy,  from  the  inability  of  the 
heart  to  propel  its  contents. 

Treatment.  — When  accompanied  by  acute  inflammation,  softening 
is  to  be  treated  on  the  same  principles  as  inflammation  of  the  heart- 
case. 

If  it  be  a result  of  chronic  inflammation,  it  calls  for  iron,  bitters, 
nutritious  animal  food,  and  good  air. 

Induration  of  the  Heart. 

The  muscular  substance  of  the  heart  sometimes  undergoes  a hard- 
ening process.  It  is  occasionally  so  much  hardened  as  to  sound, 
when  struck,  like  a hollow  horn  vessel.  The  disease  is  rare. 

It  increases  the  heart’s  impulse,  like  hypertrophy;  and  it  requires 
about  the  same  treatment  as  that  disease. 


HEART  DISEASES. 


313 


Fatty  Degeneration  of  the  Heart. 

The  heart  sometimes  becomes  overloaded  with  fat,  which  is  depos- 
ited between  the  heart-case  and  the  muscular  substance,  — covering 
the  organ  all  over  externally,  and  in  some  cases  penetrating  to  some 
depth  into  its  substance.  The  muscular  walls  themselves  become 
thin  and  flabby. 

Symptoms.  — The  sounds  of  th®  heart  are  diminished,  — especially 
the  first.  The  pulse  is  irregular.  Pain,  and  a feeling  of  oppression 
in  the  region  of  the  heart,  with  general  signs  of  retarded  circulation, 
such  as  congestion  of  the  brain  and  liver.  There  is  occasionally  gid- 
diness, loss  of  memory,  and  palpitation. 

Treatment.  — Exercise,  mental  excitement,  and  stimulating  drinks 
must  be  avoided ; and  the  patient  must  live  for  one  or  two  years  on 
a very  light  diet,  taking  but  very  little  animal  food. 

Bony  and  Cartilaginous  Productions  in  the  Heart. 

These  productions  in  the  heart  are  fortunately  rare.  Yet  they 
occur;  and  the  point  of  the  heart,  in  its  whole  thickness,  is  some- 
times changed  to  cartilage.  The  ventricles  are  sometimes  so  ossified 
as  to  resemble  the  bones  of  the  head. 

The  symptoms  of  these  degenerations  are  obscure ; and  as  such 
cases  are  not  curable,  it  is  of  less  consequence  that  we  should  be  able 
to  know  their  precise  nature  during  the  life  of  the  patient.  The 
treatment  can  only  afford  temporary  relief,  and  should  be  such  as  is 
prescribed  in  other  heart-diseases  with  similar  symptoms. 

Shrinking  of  the  Heart. — Atrophy. 

The  heart,  like  any  other  muscle,  is  liable  to  defective  nutrition, 
and  in  consequence  of  it  may  become  small.  It  shrinks,  in  some 
cases,  to  the  size  of  an  infant’s  heart. 

The  complaint  is  generally  caused  by  whatever  reduces  the  general 
flesh,  as  consumption,  diabetes,  chronic  dysentery,  cancer,  and  exces- 
sive loss  of  blood. 

It  can  hardly  be  called  a disease.  Persons  who  have  it  are  less 
subject  to  inflammatory  diseases  than  others,  though. they  faint  from 
slight  causes,  and  have  nervous  affections. 

Treatment.  — If  its  causes  can  be  discovered,  trea't  them;  if  not 
the  treatment  should  be  the  same  as  for  dilatation. 

Acute  Inflammation  of  the  Heart-Case. — Pericarditis. 

The  pericardium,  or  heart-case,  is  a membranous  sac,  in  which 
the  heart  is  contained.  It  is  composed  of  two  layers.  The  outside 


314 


HEART  diseases. 


one  is  fibrous,  dense  and  white  ; the  inside  one  is  serous.  The  serous 
layer  forms  the  lining  of  the  fibrous  one,  and  then  is  reflected  over 
the  heart  and  the  roots  of  the  large  blood-vessels. 

When  the  pericardium  becomes  acutely  inflamed,  it  throws  out 
both  lymph  and  serum  or  water.  The  lymph  often  causes  the  two 
layers  of  the  sac  to  grow  together. 

Physical  Signs.  — The  impulse  is  strong  when  the  effusion  of  water 
is  small,  — feeble  and  unequal  when  it  is  large.  Percussion  yields  a 
dull  sound  in  proportion  to  the  amount  of  fluid  in  the  sac. 

When  listening  with  the  stethoscope,  a rough  noise  is  heard,  resem- 
bling either  the  rasping  of  wood,  the  grating  of  a nutmeg,  the  rustling 
of  silk,  or  the  crackling  of  parchment.  Sometimes  it  is  softer,  like 
the  blowing  of  a pair  of  bellows.  Occasionally  it  resembles  the 
creaking  of  a new  shoe-sole,  or  has  a low  creaking,  like  the  tearing 
of  linen  cloth. 

When  there  is  effusion,  the  ordinary  beats  of  the  heart  sound  dull 
and  distant. 

General  Symptoms.  — Acute  inflammatory  fever,  generally  pre- 
ceded by  chills,  with  pungent  pain  in  the  region  of  the  heart,  shooting 
to  the  left  shoulder-blade,  shoulder,  and  upper  arm. 

Pain  increased  by  taking  a full  breath,  by  stretching  the  left  side, 
by  percussion,  and  by  pressure  between  the  ribs  over  the  heart. 
Sometimes  the  pain  is  in  the  epigastrium,  or  left  hypochondrium. 
Inability  to  lie  on  the  left  side. 

Explanation. — The  noises  mentioned  above  are  produced  by  the 
rubbing  together  of  opposite  surfaces  of  the  heart-case,  made  rough 
by  the  exudation  of  lymph.  The  rasping  is  supposed  to  be  caused 
by  firm  and  rugged  lymph ; the  rustling  and  creaking,  by  soft  and  wet 
lymph;  the  bellows  murmur,  by  so/it  and  dry  lymph;  the  creaking, 
croaking,  and  crackling,  by  dry,  tough  lymph.  These  sounds  may  all 
be  imitated  by  rubbing  a damp  finger  upon  the  back  of  the  hand, 
wlflle  listening  with  the  stethoscope  applied  to  the  palm. 

Chronic  Inflammation  of  the  Heart =Case. 

When  acute  pericarditis  runs  for  more  than  ten  days  or  a fortnight, 
it  becomes  chronic.  It  is  chronic  from  the  beginning,  when  it  runs  a 
slow,  insidious  course,  without  marked  or  violent  symptoms. 

The  symptoms  are  much  the  same  in  kind  with  those  of  the  acute 
form,  only  less  in  degree.  This  low  grade  of  the  symptoms  of  the 
disease  renders  it  more  obscure  than  the  acute. 

Treatment.  — In  the  acute  form  of  the  disease,  apply  wet  cups 
over  the  region  of  the  heart,  or  apply  from  a dozen  to  forty  leeches 
to  the  same  parts. 

At  the  same  time,  move  the  bowels  freely  by  an  injection  (247), 
or  by  a purgative  pill  (31). 


HEART  DISEASES. 


315 

The  strength  and  amount  of  the  remedies  employed  in  each  case 
must  be  in  proportion  to  the  vigor  of  the  patient’s  constitution. 

It  is  of  great  importance  that  the  treatment  should  be  active  and 
prompt,  and  that  the  disease  should  be  broken  down  early. 

Diluent,  cooling  drinks  (132),  (129),  (298),  (299),  should  be  al- 
lowed as  freely  as  the  patient  desires,  in  order  to  dilute  the  blood, 
and  render  it  less  stimulating  to  the  heart. 

At  the  same  time,  five  to  fifteen-drop  doses  of  tincture  of  veratrum 
viride  should  be  given  every  hour,  to  bring  down  the  action  of  the 
heart.  Ten-drop  doses  of  tincture  of  digitalis  every  four  hours  are 
good. 

Let  the  diet  be  wholly  of  barley-water,  thin  gruel,  weak  tea,  or 
arrow-root.  ' 

During  recovery,  the  diet  must  be  spare,  and  the  greatest  tranquil- 
lity of  mind  and  body  be  preserved. 

In  the  treatment  of  chronic  cases,  when  the  cavity  appears  to  con- 
tain fiuid,  counter-irritation  is  suitable.  Blisters,  croton-oil,  the  com- 
pound tar-plaster,  and  especially  the  tincture  of  iodine.  The  diet 
may  be  a little  more  nutritious  than  in  the  acute  form  of  the  disease, 
— embracing  light  animal  food  and  broths. 

Inflammation  of  the  Heart.  — Carditis. 

This  is  an  inflammation  of  the  muscular  substance  of  the  heart. 
When  existing  alone,  it  is  a very  rare  disease.  Being  mixed  up  with 
other  forms  of  heart  disease,  it  does  not  require  any  separate  account 
of  its  symptoms  or  treatment. 

Acute  Inflammation  of  the  Lining  of  the  Heart. 

Endocarditis. 

The  heart  is  one  of  the  citadels  of  life.  Disease  attacks  it  on  all 
sides.  In  this  complaint,  it  has  entered  the  fort  and  taken  possession. 
The  inflammation  is  on  the  lining  membrane. 

Physical  Signs.  — The  impulse  is  violent,  abrupt  and  regular,  as 
long  as  the  circulation  through  the  heart  is  free,  but  when  this  is  im- 
peded, it  is  at  first  a confused  tumult  (which  generally  happens  when 
a fort  is  first  taken),  and  gradually  sinks  to  a feeble  flutter. 

The  dull  sound  upon  percussion  covers  a space  of  from  three  to 
seven  square  inches. 

The  beats  of  the  heart  are  generally  accompanied  or  marked  by  a 
bellows  murmur,  the  loudness  of  which  depends  on  the  strength 
of  the  heart’s  action. 

General  Symptoms. — Inflammatory  fever.  The  action  of  the 
heart  being  generally  violent  and  abrupt,  the  pulse  corresponds  with 
it,  and  is  strong,  full  and  hard. 


316 


HEART  diseases. 


Explanation.  — The  bellows  sound  is  supposea  to  depend  on  the 
inflamed  and  swollen  condition  of  the  valves. 

The  dullness  on  percussion  will  be  slight  when  the  circulation 
through  the  heart  is  free ; — more  distinct  and  marked  when  it  is 
obstructed. 

Dr.  Hope  says  the  disease  may  be  anticipated,  if  a person  be  sud- 
denly attacked  with  these  three  signs : namely,  fever,  violent  action 
of  the  heart,  and  a murmur  which  did  not  exist  before. 

This  disease,  like  inflammation  of  the  hearl>case,  is  often  produced 
by,  and  is  intimately  connected  with,  acute  rheumatism,  and  is  then 
to  be  treated  on  same  principles  as  rheumatic  disorders. 

Chronic  Inflammation  of  the  Heart’s  Lining. 

Physical  Signs.  — The  impulse  more  perceptible  and  diffused  than 
natural. 

The  dull  sound  upon  percussion  covers  a space  of  from  four  to 
eight  square  inches. 

There  is  a sawing,  rasping,  or  filing  sound.  This  sound  may  cover 
one  or  both  beats  of  the  heart.  Sometimes  these  unnatural  sounds 
are  double  ; in  which  case,  the  first  is  caused  by  an  obstruction  to  the 
natural  flow  of  the  blood  forward ; the  second,  by  the  regurgitation 
or  retrograde  flow  of  the  blood  from  some  defect  in  the  valve,  — just 
as  a pump-valve  may  get  out  of  order,  and  allow  the  water  which 
has  gone  through  to  flow  back. 

Explanation.  — A variety  of  organic  changes  occur  in  the  valves, 
which  give  rise  to  the  murmurs.  Inflammation  of  the  lining  mem- 
brane of  the  heart  reaches  the  valves,  causing  puckering,  thickening, 
vegetative,  cartilaginous,  bony  and  fat-like  degenerations,  which  ob- 
struct the  blood  in  its  onward  flow,  or  prevent  a closure  of  the  valves, 
and  allow  it  to  flow  back  ; the  former  causing  the  first  sound,  the 
latter  the  second.  If  the  unnatural  noise  be  synchronous  with  the 
first  beat  of  the  heart,  it  implies  disease  in  either  set  of  the  semilunar 
valves,  or  an  impossibility  of  closing  the  auriculo-ventricular  open- 
ings ; if  it  accompany  the  second  beat,  it  signifies  that  either  set  of 
the  semilunar  valves  may  be  open. 

A murmur  attending  the  first  beat  of  the  heart  must  be  caused  by 
a current  of  blood  from  a ventricle ; one  attending  a second  sound, 
by  a like  necessity,  is  produced  by  a current  mto  a ventricle. 

Treatment. — The  same  as  that  for  pericarditis.  It  should  be 
e(\xid.\\y  prompt  and  vigorous.  It  must  not  be  forgotten  that  this  dis- 
ease leads  to  various  organic  diseases  of  the  valves  of  a very  grave 
character,  and  that  such  mischiefs  can  only  be  escaped  by  cutting  the 
disease  short  in  the  very  beginning. 


HEART  DISEASES. 


317 


Disease  of  the  Semilunar  Valves. 

The  inflammation  of  the  lining  of  the  heart  makes  sad  work  with 
the  valves.  The  semilunars  are  subject  to  various  changes  in  their 
structure. 

Physical  Signs.  — Obstructive  Murmur. — In  disease  of  the  semi- 
lunars, the  first  beat  of  the  heart  is  accompanied  or  obscured  either 
by  the  bellows  murmur,  or  a sawing,  rasping,  or  filing  sound.  The 
unnatural  murmur,  whatever  it  is,  appears  superficial  or  near.  The 
second  beat  is  natural. 

When  the  opening  into  the  aorta  is  contracted,  or  in  any  way  ob- 
structed by  unhealthy  growths,  so  that  the  blood  is  subjected  to  more 
than  a natural  degree  of  friction  in  passing,  this  sound  will  be  heard. 
It  is  called  obstructive.,  because  it  arises  from  the  obstruction  of  the 
blood  in  its  forward  course. 

Regurgitant  Murmurs. — First  beat  of  heart  natural.  Second 
beat  accompanied  or  replaced  by  bellows  murmur.  There  is  some- 
times a musical  murmur. 

Explanation.  — The  regurgitant  murmurs  arise  from  the  valves 
being  too  small,  or  defective  in  some  way,  and  allowing  the  blood  to 
flow  back  through  the  orifice. 

This  murmur  is  loudest  opposite  the  semilunar  valves,  and  is  more 
audible  above  these  valves  than  below  them. 

When  the  aortic  valves  are  contracted  or  shortened,  and  the  open- 
ings are  not  guarded  by  them,  so  as  to  prevent  the  backward  passage 
of  the  blood,  there  is  a double  bellows  murmur,  — one  when  it  is 
driven  through  the  orifice,  and  another  when  it  flows  bach. 

Disease  of  the  Mitral  Valves. 

Physical  Signs.  — Obstructive  Murmur.  — First  beat  of  heart 
natural.  Second  heat  accompanied  or  replaced  by  bellows  murmur. 

Regurgitant  Murmurs.  — The  first  beat  of  the  heart  accompanied 
by  a loud  and  rough  bellows  murmur.  This  sound  is  like  sawing  or 
filing.  It  is  loudest  above  or  below  the  nipple,  between  the  fourth 
and  seventh  ribs.  There  is  occasionally  a musical  murmur.  The 
second  beat  of  the  heart  is  natural.  Sometimes  there  is  a purring 
tremor. 

General  Symptoms  of  Valvular  Disease.  — Cough,  in  many  cases 
with  watery  expectoration ; difficulty  of  breathing ; frightful  dreams 
and  starting  from  sleep ; congestion  of  the  lungs ; expectoration 
stained  with  dark  and  grumous  blood  ; swelling  of  the  jugular  veins  ; 
a livid  look  of  the  face  ; a feeling  as  if  a cord  were  tied  tight  around 
the  lower  part  of  the  chest ; general  dropsy,  of  the  legs  and  feet  in 


318 


HEART  DISEASES. 


particular;  passive  hemorrhages  from  the  mucous  membranes;  en- 
gorgement of  the  liver  and  spleen ; congestion  of  the  brain,  with  feel-  , 
ings  of  oppression.  When  the  mitral  valve  is  contracted,  admitting 
regurgitation,  the  pulse  is  small,  weak,  irregular  and  intermittent. 

These  are  the  worst  symptoms  of  an  advanced  stage. 

Explanations.  — The  examiner  will  distinguish  the  various  sounds 
thus : 

The  murmurs  generated  at  the  origin  of  the  arteries  spread  their 
sonorous  currents  upwards  along  these  arteries. 

Those  produced  in  the  auricular  orifices  will  be  conducted  into  the 
auricles,  and  propagated  downwards  towards  the  apex  of  the  heart. 

Which  Set  of  Valves.  — To  learn  in  which  set  of  valves  it  origh 
nates,  therefore,  find  its  seat,  and  trace  its  direction. 

Finding  the  murmur  to  be  in  the  aortic  orifice.,  it  is  then  known  to 
be  obstructive.,  if  the  first  sou7id  is  morbid.,  and  the  second  sound  natu- 
ral ; and  regurgitant.,  if  the  first  sound  is  riatural.,  and  the  second  sound 
morbid. 

But  if  the  murmur  be  in  the  mitral  orifice,  it  is  obstructive  when  the 
first  beat  of  the  heart  is  natural,  and  the  second  beat  morbid ; and  re- 
gurgitant when  the  first  beat  is  morbid  and  the  seco7id  beat  natural. 

The  Pitch  or  Key  of  a murmur  depends  on  the  distance  of  its  seat 
from  the  ear  of  the  listener, — nearness  giving  a high,  and  distance  a 
low  key.  Thus,  a murmur  seated  in  tbe  orifice  of  the  pulmonary 
artery,  being  nearer  the  surface,  has  a higher  pitch  than  any  other. 
It  is  on  about  the  same  key  with  a whispered  s,  — sometimes  a little 
lower,  and  depending  somewhat  on  the  strength  of  the  current  of 
blood,  a strong  current  elevating,  and  a weak  current  depressing  the 
tone. 

The  mitral  orifice  is  situated  opposite  the  junction  of  the  cartilage 
of  the  third  rib  with  the  left  side  of  the  breast-bone.  The  aortic 
orifice  is  about  half  an  inch  to  the  right  of  this,  and  the  same  dis- 
tance lower.  It  is  known  by  the  key  being  lower,  — about  like  a 
whispered  r,  which  is  the  ordinary  type  of  the  sawing  sound. 

Murmurs  from  pulmonic  and  aortic  regurgitations  are  about  two 
tones  lower,  in  consequence  of  the  currents  of  the  blood  being  weaker. 
They  are  like  whispering  aive  by  inspiration  and  if  the  click  of  the 
valve  be  heard,  the  sound  will  be  changed  to  paw. 

Murmurs  in  the  mitral  valve,  being  more  deeply  seated,  are  about 
four  toiies  lower,  and  are  like  a whispered  who. 

The  tricuspid  murmurs  are  higher  than  the  mitral,  because  nearer 
the  surface. 

The  musical  murmur  has  been  compared  to  whistling,  the  cooing 
of  a dove,  and  the  mewing  of  a kitten.  It  generally  results  from  re- 
gurgitation. 

The  purring  tremor  is  caused,  generally,  by  regurgitation  through 
the  mitral  valve. 


HEART  DISEASES. 


319 


Other  Symptoms  Explained.  — The  difficulty  of  breathing,  fright- 
ful dreams,  congestion  of  the  lungs,  hemorrhages,  engorgements,  etc., 
mentioned  above,  all  proceed  from  such  valvular  stiffenings,  pucker- 
ings,  ossifications,  enlargements,  and  contractions,  as  occasion  a decid- 
edly obstructed  circulation. 

The  sm^l,  weak,  irregular,  and  interrupted  pulse,  is  caused  by  con- 
traction of  the  mitral  valve,  which  occasions  an  insufficient  or  irregu- 
lar supply  of  blood  to  the  ventricle,  and  causes  the  ventricle,  by  losing 
the  resistance  of  the  valve,  to  expend  its  force  in  a backward  as  well 
a forward  direction,  thus  sending  but  little  blood  into  the  arteries. 

Treatment. — The  great  object  of  treatment  is  to  diminish  the  force 
and  activity  of  the  circulation, — to  induce  the  heart  to  cease  striving 
to  do  what  cannot  be  done. 

To  accomplish  this,  give  sedatives  (285),  (94),  (124).  The  helle- 
bore and  cohosh  will  be  found  particularly  serviceable. 

The  tincture  of  the  American  hellebore  is  about  the  best  of 
all.  Purgatives  may  be  given  according  to  the  strength  of  the 
patient. 

When  there  is  dropsy,  and  a scanty  secretion  of  high-colored  urine, 
diuretics,  or  medicines  to  increase  the  action  of  the  kidneys,  are  very 
important.  For  this  purpose,  digitalis  and  acetate  of  potash  (130) 
are  excellent.  Should  this  not  succeed  in  reducing  the  dropsy,  an 
active  purgative  (31)  may  accompany  it. 

A remedy  which  comes  in  powder  form  called  diuretin,  given  in 
20  grain  doses  dissolved  in  water  every  four  hours  for  one  or  two 
days  exerts  a favorable  influence  in  many  cases.  If  no  improvement 
has  been  noticed  at  the  end  of  two  days  the  remedy  may  be  discon- 
tinued, but  it  has  worked  so  satisfactory  in  a large  per  cent,  of  cases 
that  its  use  is  justified. 

Diaphoretics,  or  medicines  which  promote  perspiration,  are  also 
useful. 

The  diet  should  be  unstimulating,  and  yet  should  be  sufficiently 
nourishing  to  prevent  the  patient  from  running  too  low.  Animal* 
food  of  the  most  digestible  kind  may  be  taken  once  a day ; though 
there  are  many  cases  requiring  its  entire  rejection. 

The  passions  should  be  kept  in  the  most  perfect  subjection,  and 
the  life  should  he  as  tranquil  is  possible.  Nothing  must  be  done  in  a 
hurry. 

Water  in  the  Heart=Case.  — Hydropericardium. 

This